Ambulance cot system

ABSTRACT

The present invention relates to ambulance cots, cot systems and methods of using the same. In particular, the present invention provides an ambulance cot comprising a hydraulic system and a tip angle monitoring, recording and alert system, and methods of using the same (e.g., to transport subjects and/or to detect and/or record operational data related to cot usage).

FIELD OF THE INVENTION

The present invention relates to ambulance cots, cot systems and methodsof using the same. In particular, the present invention provides anambulance cot comprising a hydraulic system and a tip angle monitoring,recording and alert system, and methods of using the same (e.g., totransport subjects and/or to detect and/or record operational datarelated to cot usage).

BACKGROUND OF THE INVENTION

The prevalence of overweight and obesity in the United States makesobesity a leading public health problem. The United States has thehighest rates of obesity in the developed world. From 1980 to 2002,obesity doubled in adults and overweight prevalence tripled in childrenand adolescents (See, e.g., Ogden et al., JAMA 295 (13): 1549-55). From2003-2004, of “children and adolescents aged 2 to 19 years, 17.1% wereoverweight . . . and 32.2% of adults aged 20 years or older were obese”(See, e.g., Ogden et al., 2006, JAMA 295 (13): 1549-55). The prevalencein the United States continues to rise.

Overweight and obese individuals are at increased risk for many diseasesand health conditions including hypertension (high blood pressure),osteoarthritis (a degeneration of cartilage and its underlying bonewithin a joint), type 2 diabetes, coronary heart disease, stroke,gallbladder disease, and respiratory problems.

An Emergency Medical Technician (EMT) is an emergency responder trainedto provide medical services to the ill and injured. Once thought of asan “ambulance driver or attendant,” the modern EMT performs many moreduties than in the past, and responds to many types of emergency calls,including medical emergencies, hazardous materials exposure, masscasualty/triage events, childbirth, patient transport, fires, rescues,injuries, trauma and other types of calls. EMTs may be part of anEmergency Medical Service (EMS), hospital-based EMS, fire department, orindependent response team.

EMTs are trained in practical emergency medicine and skills that can bedeployed within a rapid time frame. In general, EMT intervention aims toexpedite the safe and timely transport of a subject (e.g., to a hospitalfor definitive medical care, or from one location to another).

Thus, EMTs and others responsible for transporting patients must be ableto deal with the weight of a subject being transported. Moreover, once asubject is loaded onto a cot for transport, EMTs and others involved inpatient transport must be able to raise and lower a cot bearing asubject to various heights above the ground (e.g., raise the cot to aheight to be loaded into the back of an ambulance). In view of the factthat obesity problems continue to rise in the United States as well asother developed countries, and that these subjects appear to be moreprone to a need for emergency medical care, EMTs and other emergencymedical service personnel are encountering the need to lift andtransport heavier patients. This in turn has led to injuries (e.g.,musculoskeletal injuries) as a result of overexertion lifting becomingone of the most common injuries in the EMT/EMS workforce.

SUMMARY OF THE INVENTION

The present invention relates to ambulance cots, cot systems and methodsof using the same. In particular, the present invention provides anambulance cot comprising a hydraulic system and a tip angle monitoring,recording and alert system, and methods of using the same (e.g., totransport subjects and/or to detect and/or record operational datarelated to cot usage).

Accordingly, in some embodiments, the present invention provides ahydraulically powered cot, wherein the cot comprises: A) a pair offrames, wherein the pair of frames comprise: 1) a base frame, whereinthe base frame comprises a foot-end cross tube and a head-end crosstube, wherein each of the cross tubes are fastened on each end to aconnector, wherein a first connector attached to the head-end cross tubeis irremovably attached to a first rail that is irremovably attached toa first connector attached to the foot-end cross tube, and wherein asecond connector attached to the head-end cross tube is irremovablyattached to a second rail that is irremovably attached to a secondconnector attached to the foot-end cross tube; and 2) a top frame,wherein the top frame comprises: i) a slider housing affixed to thefoot-end portion of the top frame; and ii) a telescoping load railassembly, wherein the assembly comprises wheels that are utilized forrolling the cot out of and into a deck of an ambulance; and iii) aplurality of cross tubes and cross tube castings, wherein the pluralityof cross tubes comprise a foot-end cross tube, a head-end cross tube anda middle region cross tube, wherein the top frame is attached to a teamlift rail, wherein the team lift rail surrounds the foot-end region andboth sides of the top frame, wherein the team lift rail located on oneside of the top frame is attached to the team lift rail located on theother side of the top frame via the plurality of cross tubes and crosstube castings, wherein the cross tubes are fastened to the cross tubecastings, wherein the castings are fastened to the top frame andcomprise an orifice into and/or through which the team lift railsextend; B) a patient litter formed of roto-molded plastic (e.g.,comprising lower leg, upper leg, lower torso and/or upper torsosections); C) a fixed leg assembly comprising a pair of fixed-lengthlegs, wherein the fixed-length legs are parallel to each other, andwherein the fixed-length legs are pivotably connected to the foot-endcross tube of the base frame, and wherein the fixed-length legs arepivotably attached to the head-end cross tube of the top frame; D) atelescoping leg assembly comprising a pair of telescoping legs, whereinthe telescoping legs are parallel to each other, and wherein thetelescoping legs comprise: i) a main rail, wherein the main railcomprises a top side and bottom side, wherein the top side of the mainrail comprises an extruded portion fastened to the main rail thatcomprises a roller bearing, wherein the roller bearing rolls along thetop side of the inner rail when the cot is raised or collapsed, whereinthe main rails are fastened to each other via a cross tube that isirremovably attached to each of the extruded portions of the main rails,and wherein the main rails are attached to a cross tube residing in theslider housing affixed to the foot-end portion of the top frame; and ii)an inner rail, wherein the inner rail comprises a top side and a bottomside, wherein one or more roller bearings are connected to a top portionand one or more roller bearings are connected to a bottom portion of theinner leg, wherein the roller bearings roll along the inside face of thetop side and the inside face of the bottom side of the main rail whenthe cot is raised or collapsed, wherein the inner rails are pivotablyattached to the head-end cross tube of the base frame, wherein theroller bearings reduce frictional force associated with increase inlength of the telescoping legs that occurs with raising of the patientlitter and the frictional force associated with the decrease in lengthof the telescoping legs that occurs with lowering of the patient litter;E) a hydraulic system, wherein the hydraulic system comprises a cylinderpowered by a hydraulic unit, wherein one end of the cylinder is attachedto a cylinder base pivot, wherein the cylinder base pivot is pivotablyattached to the foot-end cross tube of the base frame, and wherein theother end of the cylinder is attached to a cylinder cross member,wherein the cylinder cross member is fastened to each of the main railsof the telescoping legs; F) a tip angle monitoring, recording and alertsystem, wherein the tip angle system comprises: a pressure transducer,wherein the pressure transducer is located within the hydraulic system,detects hydraulic system pressure and converts the pressure to voltageinformation; an ultrasonic sensor, wherein the ultrasonic sensor ismounted on the slider housing, wherein the ultrasonic sensor measuresthe distance between the sensor and a slider block attached to the crosstube attached to the main rails of said telescoping legs residing in theslider housing, wherein the distance represents the distance between theground and the wheels of the telescoping load rail assembly; and acircuit board, wherein the circuit board is located within a controllerhousing fastened to lift handles surrounding the foot-end of the topframe, wherein the circuit board comprises: i) a controller, wherein thecontroller monitors and records the voltage information of the pressuretransducer, wherein the controller processes the voltage information tocalculate load weight on the cot; ii) a processor; iii) a memorycomponent; iv) an accelerometer, wherein the accelerometer is configuredto measure in degrees the angle of movement from side to side of thecircuit board with respect to a horizontal plane that is perpendicularto the earth's gravitational force; and iv) a firmware componentcomprising an algorithm, wherein the firmware and algorithm areconfigured to calculate and record cot tip angle utilizing: a) cot loadmeasured by the pressure transducer; b) cot height measured by theultrasonic sensor; and c) cot angle measured by the accelerometer; G) anon-series wired, two battery power system, wherein the system powersthe hydraulic and electrical components of the cot; and H) a controlpanel (e.g., user interface), wherein the control panel comprises iconindicators for service information, hydraulic system information, andtip angle information; wherein the cot is configured to raise and lowera subject (e.g., weighing between 20 and 100 pounds (e.g., greater than100 pounds, greater than 200 pounds, greater than 300 pounds, greaterthan 400 pounds, greater than 500 pounds, greater than 600 pounds (e.g.,650 or more pounds (e.g., unassisted (e.g., without the assistance oflifting energy exerted by one or more persons (e.g., EMS persons)))))).For example, although a cot of the present invention may be capable oflifting greater than 600 pounds unassisted, in some embodiments, therated load of a cot provided herein is 600 pounds. In some embodiments,the cot further comprises hand lever-operated brakes. In someembodiments, the firmware component is housed within the controller. Insome embodiments, the tip angle monitoring, recording and alert systemcaptures and records cot operational use information. The presentinvention is not limited by the type of cot operational use informationcaptured and recorded (e.g., that relates to the cot's usage). In someembodiments, cot operational use information comprises cot operationangles (e.g., comprising safe and/or unsafe angles of the cot (e.g.,occurring during cot use (e.g., during patient transport))). In someembodiments, cot operational use information comprises cot angle, cotheight, cot load weight, calendar date, and/or time. In someembodiments, the tip angle monitoring, recording and alert systemcomprises audio and/or visual alerts (e.g., that warn a user of anunsafe operational cot angle). For example, in some embodiments, theaudio alert comprises a pulsed tone signal or a solid tone signal. Insome embodiments, the pulsed tone signal sounds when the cot tip angleis within a certain number of degrees from the tipping point. Forexample, in some embodiments, the pulsed tone signal sounds when the cottip angle is identified (e.g., by the components of the tip anglemonitoring, recording and alert system (e.g., by the algorithm) to bethree degrees or less from the tipping point of the cot. In someembodiments, the pulsed tone signal sounds when the cot tip angle isidentified (e.g., by the components of the tip angle monitoring,recording and alert system (e.g., by the algorithm) to be five degreesor less from the tipping point of the cot. In some embodiments, thepulsed tone signal sounds when the cot tip angle is identified (e.g., bythe components of the tip angle monitoring, recording and alert system(e.g., by the algorithm) to be seven degrees or less from the tippingpoint of the cot. The present invention is not limited to these amounts.Indeed, a pulsed tone signal may sound when the cot tip angle isidentified to be any desired degree (or less) from the tipping point ofthe cot (e.g., 3, 5, 7, 9, 10, 15, less than 3 or more than 15 degrees).In some embodiments, a solid tone signal sounds when the cot tip anglereaches the tipping point of the cot. In some embodiments, the tip anglemonitoring, recording and alert system communicates with the controllerto preclude raising of the cot (e.g., when the system detects a certaintip angle (e.g., 3, 5, 7, 9, 10, 15, less than 3 or more than 15 degreesfrom a tipping point)). In some embodiments, the cot comprises aweighing function (e.g., comprising a push button on the control panel(e.g., user interface), wherein when the push button is pressed, a cotload weight is displayed (e.g., on the control panel) by the cot). Insome embodiments, the load weight is displayed in pounds. In someembodiments, the load weight is displayed in kilograms. In someembodiments, the memory component comprises one or a plurality of memorychips. The present invention is not limited by the type of memory chipsutilized. Indeed, a variety of memory chips may be utilized including,but not limited to, dynamic random access memory (DRAM) chips, FLASHmemory chips, static random access memory (SRAM) chips, specialty memorychips, ferroelectric random access memory (FRAM) chips, electricallyerasable programmable read-only memory (EEPROM) chips, first-in,first-out (FIFO) memory chips, erasable programmable read-only memory(EPROM) chips, non-volatile random access memory (NVRAM) chips, memorycards, a collection of chips (e.g., SRAM modules, DRAM modules, etc.),etc. In some embodiments, the memory component stores operational useinformation. In some embodiments, the operational use information isonly accessible to an administrator. In some embodiments, the firmwarecomponent is accessible via a USB port. In some embodiments, cotoperational use information can be removed from the memory component(e.g., using a USB port (e.g., to move operational use information toanother memory (e.g., data storage) device)). In some embodiments,roller bearings reduce frictional force of the telescoping legs. In someembodiments, reducing frictional force of the telescoping legs reduceshydraulic system pressure. In some embodiments, reducing frictionalforce of the telescoping legs reduces battery current draw. In someembodiments, reducing frictional force of the telescoping legs extendsthe usable life of the cot. In some embodiments, the cot furthercomprises one or more hall effect switches configured to regulate powerto the hydraulic system.

In some embodiments, the present invention provides a cot tip anglemonitoring, recording and alert system, wherein the tip angle systemcomprises: a pressure transducer; an ultrasonic sensor; and anaccelerometer. In some embodiments, the tip angle monitoring, recording,and alert system further comprises a circuit board. In some embodiments,the circuit board is fastened to the cot. In some embodiments thecircuit board comprises: i) a controller; ii) a processor; iii) a memorycomponent; and iv) a firmware component comprising an algorithm, whereinthe firmware and algorithm are configured to calculate and record cottip angle. In some embodiments, cot tip angle is calculated utilizingcot load measured by the pressure transducer. In some embodiments, cottip angle is calculated utilizing cot height measured by the ultrasonicsensor. In some embodiments, cot tip angle is calculated utilizing cotangle measured by the accelerometer. In some embodiments, the algorithmutilizes each of cot load, cot height and cot angle to determine cot tipangle. In some embodiments, the pressure transducer is located within ahydraulic system. In some embodiments, the pressure transducer detectshydraulic system pressure and converts the pressure to voltageinformation. In some embodiments, the controller monitors and recordsthe voltage information of the pressure transducer. In some embodiments,the controller processes the voltage information to calculate loadweight on the cot. In some embodiments, the ultrasonic sensor is mountedin a location on the cot that measures the height of the cot (e.g.,directly or indirectly (e.g., via measuring the distance between theultrasonic sensor and a movable component of the cot that is closer toor further from the sensor depending upon whether the cot is raised orlowered. In some embodiments, the accelerometer is configured to measurein degrees the angle of movement from side to side of the cot withrespect to a horizontal plane that is perpendicular to the earth'sgravitational force.

In some embodiments, the present invention provides a cot tip anglemonitoring, recording and alert system, wherein the tip angle systemmonitors and records, in real-time, cot operational use information. Insome embodiments, cot operational use information comprises the tipangle of said cot. The present invention is not limited by the type ofcot operational use information monitored and recorded (e.g., thatrelates to the cot's usage). In some embodiments, cot operational useinformation comprises cot operation angles (e.g., comprising safe and/orunsafe angles of the cot (e.g., occurring during cot use (e.g., duringpatient transport))). In some embodiments, cot operational useinformation comprises cot angle, cot height, cot load weight, calendardate, user identification, and/or time. In some embodiments, recordedcot operational use information is saved in a memory component of thesystem. The present invention is not limited by the type of memory usedfor recording the cot operational use information. In some embodiments,the memory is an internal or external hard drive. In some embodiments,the memory is a jump drive. In some embodiments, the memory is a memorychip described herein. In some embodiments, the cot operational useinformation is only retrievable from the memory component by anauthorized user. In some embodiments, the authorized user is anadministrator.

The present invention also provides a hydraulic system for use in ahydraulically powered cot. For example, in some embodiments, the presentinvention provides a hydraulic system depicted in FIGS. 1 and 44-52.

The present invention also provides an ambulance cot (e.g., a manual cotor a hydraulically powered cot) comprising a telescoping leg assemblycomprising a roller bearing system. In some embodiment, the telescopingleg assembly comprising a roller bearing system comprises both a main,outer rail and an inner rail. In some embodiments, the main railcomprises a top side and bottom side, wherein the top side of the mainrail comprises an extruded portion fastened to the main rail thatcomprises a roller bearing, wherein the roller bearing rolls along thetop side of the inner rail (e.g., when the telescoping leg assembly isexpanded (e.g., when the cot is raised) or contracted (e.g., when a cotis lowered or collapsed). In some embodiments, a cot comprises twotelescoping leg assemblies (e.g., with each comprising a roller bearingsystem) that are parallel to each other wherein the main rails of eachtelescoping leg assembly are fastened to each other via a cross tubethat is irremovably attached to each of the extruded portions of themain rails. In some embodiments, a cot comprises four telescoping legassemblies (e.g., with each comprising a roller bearing systems). Insome embodiments, the inner rail comprises a top side and a bottom side,wherein one or more roller bearings (e.g., two, three, four or more) areconnected to a top portion and one or more roller bearings (e.g., two,three, four or more) are connected to a bottom portion of the inner leg,wherein the roller bearings roll along the inside face of the top sideof the main rail and the inside face of the bottom side of the main railwhen the telescoping leg is expanded (e.g., when a cot is raised) orcontracted (e.g., when a cot is lowered or collapsed). In someembodiments, the roller bearing system reduces frictional force of thetelescoping legs (e.g., the frictional force associated with an increaseor decrease in length of the telescoping legs (e.g., that occurs withraising or lowering of the cot). In some embodiments, reducingfrictional force of the telescoping legs reduces hydraulic systempressure. In some embodiments, reducing frictional force of thetelescoping legs reduces battery current draw. In some embodiments,reducing frictional force of the telescoping legs extends the usablelife of the cot (e.g., by reducing hydraulic system pressure and/orreducing battery current draw).

DESCRIPTION OF DRAWINGS

FIG. 1 shows an illustrated side view of a cot according to theinvention in a fully raised position.

FIG. 2 shows an illustrated side view of a cot according to theinvention in (A) a fully raised and (B) a fully collapsed position.

FIG. 3 shows components of the base frame, wheels and leg assemblies ofa cot according to the invention.

FIGS. 4A-4E show components of a hand braking mechanism of oneembodiment of the invention.

FIG. 5 shows components of a foot brake of one embodiment of theinvention.

FIG. 6 shows base frame, fixed-leg assembly and telescoping leg assemblycomponents of a cot in a fully collapsed position of one embodiment ofthe invention.

FIG. 7 shows base frame, fixed-leg assembly and telescoping leg assemblycomponents of a cot in a position such that the a patient litter, ifattached, would be in a level position of one embodiment of theinvention.

FIG. 8 shows base frame, fixed-leg assembly and telescoping leg assemblycomponents of a cot in a fully raised position of one embodiment of theinvention.

FIG. 9 shows a view of the telescoping leg assembly of a cot of oneembodiment of the invention.

FIG. 10 shows a view of the telescoping leg assembly wherein the mainrail has been made transparent (represented by the plurality of parallellines) thereby providing a view of the inner rail and rollers attachedthereto, in one embodiment of the invention.

FIG. 11 shows a view of the telescoping leg assembly wherein the mainrail has been made transparent (represented by the plurality of parallellines) thereby providing a view of the inner rail (shaded) includingopenings therein, and rollers attached thereto and extruding therefrom,in one embodiment of the invention.

FIG. 12 shows a view of connections of some of the components of ahydraulic system of a cot in one embodiment of the present invention.

FIG. 13 shows a view of the top of a cot in one embodiment of theinvention, including the top frame and team lift rail, with patientlitter components removed.

FIG. 14 shows a view of foot end components of a cot in a fully raisedposition, with patient litter components removed, in one embodiment ofthe present invention.

FIG. 15 shows a view of foot end components of a cot in a position suchthat the patient litter is in a level position in one embodiment of thepresent invention.

FIG. 16 shows a view of foot end components of a cot in a fullycollapsed position in one embodiment of the present invention.

FIG. 17 shows a view of the bottom of a cot in one embodiment of theinvention, including the base frame, leg assemblies, top frame and teamlift rail, with patient litter components removed.

FIG. 18 shows a view of a side rail in one embodiment of the invention.

FIG. 19 shows components within a rail handle, drawn transparently, inone embodiment of the invention.

FIG. 20 shows a view of the top of a cot in one embodiment of theinvention, including the top frame, team lift rail, and components forconnecting a patient litter, in the absence of the patient litter.

FIG. 21 shows components of a knee gatch detent assembly from both (A) atopside and (B) a side view in one embodiment of the invention.

FIG. 22 shows the knee gatch detent assembly and its attachment to thelitter leg tube via gatch pivots in one embodiment of the invention.

FIG. 23 shows attachment of a leg litter to the knee gatch pivot in oneembodiment of the invention.

FIG. 24 shows components of a knee gatch detent assembly, patient litterattachments and a leg litter portion of a patient litter in a raisedposition in one embodiment of the invention.

FIG. 25 shows a leg litter portion of a patient litter in a non-raisedposition in one embodiment of the invention.

FIG. 26 shows a leg litter portion and a thigh litter portion and othercomponents of a cot in one embodiment of the invention.

FIG. 27 shows a seat/lower torso litter portion and other components ofa cot in one embodiment of the invention.

FIG. 28 shows a head/upper torso litter portion and other components ofa cot in one embodiment of the invention.

FIG. 29 shows a cot in one embodiment of the invention in (A) a flat,(B) elevated backrest (upper torso or Fowler's position) and knee-gatchposition; and (C) a Trendelenburg (shock) position.

FIG. 30 shows attachment points for a hydraulic system to a cot in oneembodiment of the invention.

FIG. 31 shows components of a hydraulic system in one embodiment of theinvention.

FIG. 32 shows components of a hydraulic system in one embodiment of theinvention.

FIG. 33 shows components of a manual release for a hydraulic system inone embodiment of the invention.

FIG. 34 shows components of a hydraulic system including a pressuretransducer in one embodiment of the invention.

FIG. 35 shows components of a telescoping load rail assembly in oneembodiment of the invention.

FIG. 36 shows components of a telescoping load rail assembly in oneembodiment of the invention.

FIG. 37 shows components of a load rail release assembly in oneembodiment of the invention.

FIG. 38 shows components of a load rail release assembly in oneembodiment of the invention.

FIG. 39 shows the positioning of one or more hall effect switches in oneembodiment of the invention.

FIG. 40 shows the location of a hand brake lever in one embodiment ofthe invention.

FIG. 41 shows the location of push button controls and manual releaselever for a hydraulic system of one embodiment of the invention.

FIG. 42 shows the location of a manual release lever in an opened(released) position).

FIG. 43 shows a telescoping intravenous (IV) pole connected to the teamrail assembly in one embodiment of the invention.

FIG. 44 shows valve configuration of a hydraulic system manifold in oneembodiment of the invention.

FIG. 45 shows valve configuration of a hydraulic system manifold duringa powered raising of the legs of a cot in one embodiment of theinvention.

FIG. 46 shows valve configuration of a hydraulic system manifoldsupporting a load upon a cot (e.g., a subject) in one embodiment of theinvention.

FIG. 47 shows valve configuration of a hydraulic system manifold duringa controlled lower of a cot in one embodiment of the invention.

FIG. 48 shows valve configuration of a hydraulic system manifold duringa manual collapse of a cot with a load (e.g., a subject) in oneembodiment of the invention.

FIG. 49 shows valve configuration of a hydraulic system manifold duringa powered quick collapse of a cot in one embodiment of the invention.

FIG. 50 shows valve configuration of a hydraulic system manifold duringa manual collapsing of a cot via lifting of leg assemblies in oneembodiment of the invention.

FIG. 51 shows valve configuration of a hydraulic system manifold whileholding cot legs up in one embodiment of the invention.

FIG. 52 shows valve configuration of a hydraulic system manifold duringa manual raising of a cot via lowering the legs (e.g., with a head-endportion of the cot resting on an ambulance deck) in one embodiment ofthe invention.

FIG. 53 shows a multiple layer cot system of the present invention.

FIG. 54 shows stacked litters of a multiple layer cot system of thepresent invention.

FIG. 55 shows attachment of a controller housing to the foot-end portionof a cot in one embodiment of the invention.

FIG. 56 shows a diagram of a power console/control panel overlay in oneembodiment of the invention.

FIG. 57 shows a diagram of the cot location of an intravenous (IV) polein one embodiment of the invention.

FIG. 58 shows a diagram of components of an IV pole in one embodiment ofthe invention.

FIG. 59 shows a diagram of components of an IV pole in one embodiment ofthe invention, with the position grip not shown and only one pivothousing.

FIG. 60 shows a diagram of components of an IV pole in one embodiment ofthe invention.

FIG. 61 shows a diagram of components of an IV pole in one embodiment ofthe invention, shown in a sectioned format without IV stage 2.

FIG. 62 shows a diagram of components of an IV pole in one embodiment ofthe invention.

FIG. 63 shows a diagram of components of a cot generated and tested inone embodiment of the invention.

FIG. 64 shows a diagram of components of a cot generated and tested inone embodiment of the invention.

FIG. 65 shows a diagram of components of a cot generated and tested inone embodiment of the invention.

FIG. 66 shows a table of the maximum system pressure recorded during ahydraulically powered lift of 300 pounds using various cots generatedand tested in embodiments of the invention.

FIG. 67 shows a table depicting how hydraulic system pressure correlateswith energy consumption.

FIG. 68 shows a diagram depicting tip angle of a cot comprising a tipangle monitoring, recording and alert system of the present invention.

FIG. 69 shows a table comprising height, weight and tip angles for a cotof one embodiment of the present invention.

DEFINITIONS

To facilitate an understanding of the present invention, a number ofterms and phrases are defined below:

As used herein, the term “subject” refers to a human or other vertebrateanimal. It is intended that the term encompass patients.

As used herein, the term “amplifier” refers to a device that produces anelectrical output that is a function of the corresponding electricalinput parameter, and increases the magnitude of the input by means ofenergy drawn from an external source (i.e., it introduces gain).“Amplification” refers to the reproduction of an electrical signal by anelectronic device, usually at an increased intensity. “Amplificationmeans” refers to the use of an amplifier to amplify a signal. It isintended that the amplification means also includes means to processand/or filter the signal.

As used herein, the term “receiver” refers to the part of a system thatconverts transmitted waves into a desired form of output. The range offrequencies over which a receiver operates with a selected performance(i.e., a known level of sensitivity) is the “bandwidth” of the receiver.

As used herein, the term “transducer” refers to any device that convertsa non-electrical parameter (e.g., sound, pressure or light), intoelectrical signals or vice versa.

The term “circuit” as used herein, refers to the complete path of anelectric current.

As used herein, the term “resistor” refers to an electronic device thatpossesses resistance and is selected for this use. It is intended thatthe term encompass all types of resistors, including but not limited to,fixed-value or adjustable, carbon, wire-wound, and film resistors. Theterm “resistance” (R; ohm) refers to the tendency of a material toresist the passage of an electric current, and to convert electricalenergy into heat energy.

The term “housing” refers to the structure encasing or enclosing atleast one component (e.g., circuit board) of the devices of the presentinvention. In some embodiments, the housing comprises at least onehermetic feedthrough through which leads extend from the componentinside the housing to a position outside the housing.

As used herein, the term “hermetically sealed” refers to a device orobject that is sealed in a manner that liquids or gases located outsidethe device are prevented from entering the interior of the device, to atleast some degree. “Completely hermetically sealed” refers to a deviceor object that is sealed in a manner such that no detectable liquid orgas located outside the device enters the interior of the device. It isintended that the sealing be accomplished by a variety of means,including but not limited to mechanical, glue or sealants, etc. Inparticularly preferred embodiments, the hermetically sealed device ismade so that it is completely leak-proof (i.e., no liquid or gas isallowed to enter the interior of the device at all).

As used herein the term “processor” refers to a device that is able toread a program from a computer memory (e.g., ROM or other computermemory) and perform a set of steps according to the program. Processormay include non-algorithmic signal processing components (e.g., foranalog signal processing).

As used herein, the terms “memory component,” “computer memory” and“computer memory device” refer to any storage media readable by acomputer processor. Examples of computer memory include, but are notlimited to, RAM, ROM, computer chips, digital video disc (DVDs), compactdiscs (CDs), hard disk drives (HDD), and magnetic tape.

As used herein, the term “computer readable medium” refers to any deviceor system for storing and providing information (e.g., data andinstructions) to a computer processor. Examples of computer readablemedia include, but are not limited to, DVDs, CDs, hard disk drives,magnetic tape, flash memory, and servers for streaming media overnetworks.

As used herein the terms “multimedia information” and “mediainformation” are used interchangeably to refer to information (e.g.,digitized and analog information) encoding or representing audio, video,and/or text. Multimedia information may further carry information notcorresponding to audio or video. Multimedia information may betransmitted from one location or device to a second location or deviceby methods including, but not limited to, electrical, optical, andsatellite transmission, and the like.

As used herein, the term “Internet” refers to any collection of networksusing standard protocols. For example, the term includes a collection ofinterconnected (public and/or private) networks that are linked togetherby a set of standard protocols (such as TCP/IP, HTTP, and FTP) to form aglobal, distributed network. While this term is intended to refer towhat is now commonly known as the Internet, it is also intended toencompass variations that may be made in the future, including changesand additions to existing standard protocols or integration with othermedia (e.g., television, radio, etc). The term is also intended toencompass non-public networks such as private (e.g., corporate)Intranets.

As used herein the term “security protocol” refers to an electronicsecurity system (e.g., hardware and/or software) to limit access toprocessor, memory, etc. to specific users authorized to access theprocessor. For example, a security protocol may comprise a softwareprogram that locks out one or more functions of a processor until acertain event occurs (e.g., until an appropriate password is entered,authorized radio-frequency identification (RFID) tag is presented,proper biometric match is made, or the like).

As used herein the term “resource manager” refers to a system thatoptimizes the performance of a processor or another system. For examplea resource manager may be configured to monitor the performance of aprocessor or software application and manage data and processorallocation, perform component failure recoveries, optimize the receiptand transmission of data, and the like. In some embodiments, theresource manager comprises a software program provided on a computersystem of the present invention.

As used herein the term “in electronic communication” refers toelectrical devices (e.g., computers, processors, communicationsequipment) that are configured to communicate with one another throughdirect or indirect signaling. For example, a conference bridge that isconnected to a processor through a cable or wire, such that informationcan pass between the conference bridge and the processor, are inelectronic communication with one another. Likewise, a computerconfigured to transmit (e.g., through cables, wires, infrared signals,telephone lines, etc) information to another computer or device, is inelectronic communication with the other computer or device.

As used herein the term “transmitting” refers to the movement ofinformation (e.g., data) from one location to another (e.g., from onedevice to another) using any suitable means.

DETAILED DESCRIPTION OF THE INVENTION

The present invention relates to ambulance cots, cot systems and methodsof using the same. In particular, the present invention provides anambulance cot comprising a hydraulic system and a tip angle monitoring,recording and alert system, and methods of using the same (e.g., totransport subjects and/or to detect and/or record operational datarelated to cot usage).

The following embodiments are provided by way of example and are notintended to limit the invention to these particular configurations.Numerous other applications and configurations will be appreciated bythose of ordinary skill in the art.

An ambulance cot system of the present invention is depicted in thedrawings. For example, an ambulance cot system 1 embodied by theinvention is shown in FIGS. 1-52. In some embodiments, the ambulance cotsystem 1 comprises a pair of frames comprising a base frame 10 and a topframe 74 as shown, for example, in FIGS. 1 and 2. The base frame 10includes a foot-end cross tube 12 and a head-end cross tube 11, aplurality of base connectors 16 and base side rails 13. In someembodiments, the cross tubes 11,12 are connected on each end to a baseconnector 16, as are the base side rails 13 (e.g., as shown in FIG. 3).The base connectors 16 provide a foot placement point (e.g., non-slipfoot placement point) for a user of the cot (e.g., for placement of theuser of the cot in a position above a subject upon the cot).

As shown in FIG. 3, the base frame 10 can be connected via each baseconnector 16 to castor forks 14 that attach to wheels 15. The presentinvention is not limited by the type of wheels utilized. In someembodiments, cot wheels are constructed of rubber, plastic, composite(e.g., polycarbonate), or other type of material. It is preferred thatthe wheel material is not too hard (e.g., thereby reducing vibrationartifacts (e.g., while the cot is in motion over a surface and/or whilethe cot is mounted in a moving ambulance)) nor too soft or porous (e.g.,such that debris (e.g., rocks, glass, mud, etc.) could collect and/orbuild up in and/or on the wheels). Thus, the wheels are an importantcomponent of the cot in that by decreasing vibration artifacts (e.g., byutilizing a wheel with an optimal durometer) they can reduce the risk oferroneous readings of a subject's vital signs (e.g., blood pressure,heart monitor, EKG tracings, etc.) that might otherwise occur (e.g., dueto vibration artifacts that occur with use of poorly constructedwheels). In some embodiments, cot wheels comprise greaseless, sealedbearings (e.g., titanium or other metallic bearing (e.g., that prevententrance of patient body fluids, water, snow, or other fluids). In someembodiments, the bearings provide a smooth roll of the cot and permit auser to maneuver the cot more easily (e.g., with less back twist and/ortorsion). In some embodiments, wheel bearings prevent wheel wobble.

The present invention is not limited by the size of the wheels utilized.In some embodiments, the diameter of the wheels utilized is greater than6.5 inches, although larger (e.g., greater than 6.7 inches, greater than7 inches, greater than 7.5 inches, greater than 8 inches or larger) andsmaller (e.g., diameter greater than 3 inches, greater than 4 inches,greater than 4.5 inches, greater than 5 inches, greater than 6 inches)are utilized. In some embodiments, the width of a wheel is 1-1.5 inches,1.5-2.0 inches, 2.0-2.5 inches, 2.5-3.0 inches, 3.0-3.5 inches orlarger. In some embodiments, the wheels utilized are 6.5 inches indiameter and are 2.25 inches wide. Wider wheels provide superiorhandling and maneuverability over rough terrain and also provide a lowerinitial push weight to get a cot moving (e.g., rolling). In someembodiments, cot wheels comprise a customizable trim ring on thesidewall of the wheel (e.g., that permit users (e.g., purchasers of acot of the present invention)) to customize the cot (e.g., the wheels).In some embodiments, a user may utilize alpha numeric characters forcustomization (e.g., for departmental customization (e.g., City Fire,City EMS, etc.). The trim ring and/or alpha numeric characters may beany color (e.g., thereby permitting easy recognition of a cot (e.g.,thereby reducing “cot confusion” in a mass casualty or multiple serviceresponse)). In some embodiments, the wheels comprise a camber (e.g.,that provides the least amount of resistance to roll while providingsufficient surface contact for maximum traction). In some embodiments,the wheels comprise a tread pattern that permits maximum traction,water, snow and/or ice displacement, and/or low resistance. In someembodiments, the wheels are utilized in the context of an independentsuspension and/or traction control system. In some embodiments, wheelrotation is utilized to generate electric power and/or to charge one ormore batteries associated with the cot's use.

A castor fork 14 that is connected to a cot wheel 15 is designed toprevent bearing wear at the top of the castor where it connects androtates about a base connector 16. In some embodiments, the top castorbearing is constructed of a material that allows maximum rotation andthat prevents the bearing from cracking and disintegrating (e.g., TEFLONor other suitable material known to those of ordinary skill in the art).

As illustrated in FIGS. 4A-4C, the base connectors 16 attached to thefoot-end cross tube 12 can also attach to connector covers 17 that housea hand brake ramping mechanism 2. In some embodiments, the hand brakesallow a cot user (e.g., EMT, fire department personnel, etc.) to controlthe speed of the cot (e.g., while in motion (e.g., thereby providingunprecedented safety for a subject on the cot)). Thus, a hand brakesystem provided herein allows a cot to be used under conditions that norapid stops of the cot occur (e.g., ameliorating twisting and stressplaced on a cot user's back and legs) and also reduces the risk ofunsafe cot speed and/or movements (e.g., thereby preventing tipping of acot).

In some embodiments, a hand braking system provided herein works bytransferring motion created by the user to the wheels, causing atemporary interference at the wheel. For example, in some embodiments, auser applies a force to a lever 208 that is connected to the hand brakelever cable 20, which allows for a linear motion to be transferred. Thesingle hand brake lever cable 20 is connected to two other hand brakelever cables via hand brake pull block 243 that act on 2 differentwheels, allowing a single lever 208 to actuate 2 separate brakes. Ateach wheel, the hand brake lever cable 20 is connected to a rotaryramped lifter 22 that transfers the linear motion from the cable to arotary motion. That rotary motion is then converted back to a linearmotion via the cam surface of the linear ramped lifter 21, and is liftedup. The brake arm cable 25 connects the linear ramped lifter 21 and thebrake arm 28. The linear motion of the linear ramped lifter 21 is usedto pivot the brake arm 28, which pivots into the outside diameter of thewheel. A hand brake ramping mechanism 2 of the invention may beconfigured as shown in FIGS. 4A-4C.

The hand brake lever cable 20 connects to the lever 208 via a cable stop32 located in a pocket. The lever 208 is attached to the tube 190 byhaving a shoulder screw run through the lever 208 pivot. The hand brakelever mount top and hand brake lever mount bottom retain the lever byhaving the shoulder screw attached. The shoulder screw can be tightened,but still allow for clearance for the lever to rotate. The hand brakelever mount top and hand brake lever mount bottom are attached to thetube 190 by a screw that runs through a hole in the tube 190. The lever208 is actuated approximately 45 degrees, and is stopped by the tube 190to limit travel. The hand brake lever cable 20 goes to the hand brakecable mount where a threaded end of the covering sheath is attached tothe plate. The threaded end allows for adjustment of the length of thehand brake cable to account for manufacturing conditions. The hand brakelever cable 20 end mounts to the hand brake pull block 243 via cablestop 32, and two other hand brake lever cables 20 are attached via cablestops 32. The force and motion of the first hand brake lever cable 20 istransferred to the second two, allowing for two brakes to be usedsimultaneously. The second two hand brake lever cables are attached tothe same hand brake cable mount via threaded ends. The threaded endsallow for adjustment of the cable length to account for manufacturingconditions. At each wheel, the hand brake lever cable 20 pulls on therotary ramped lifter 22 and rotates it approximately 90 degrees. Thehand brake lever cable 20 is covered in a sheath that has a slottedmetal end to allow for it to be located on the connector cover 17 withthe hand brake cable locator 29. The hand brake cable locator 29 isriveted to the connector cover and has a tab that fits into the handbrake lever cable 20 locator slot. The hand brake lever cable 20 has acable stop 32 on the end that is located in a pocket of the rotaryramped lifter 22. The rotary ramped lifter 22 has a slot to allow forclearance. The rotary ramped lifter 22 is housed in a connector cover 17which constrains the outside diameter of the rotary ramped lifter 22 andthe thrust washer 23 constrains the rotary ramped lifter 22. The thrustwasher 23 is constrained by the base connector 16 and the connectorcover 17. The thrust washer 23 is used to reduce friction of the bottomsurface of the rotary ramped lifter 22. The linear ramped lifter 21 isconstrained in the connector cover 17 by two tabs that do not allow forrotary motion, only linear. The cam surface of the rotary ramped lifter22 pushes onto the linear ramped lifter 21 and moves it upwards (e.g.,approximately 0.280 inches, or more) during braking. The rotary rampedlifter is biased such that the brake is relaxed (e.g., collapsed) by wayof a torsion spring between linear ramped lifter and the rotary rampedlifter. The brake arm cable 25 is constrained in a pocket of the linearramped lifter 21 by a cable stop 32 on its end, and is located at thecenter of the wheel caster rotation. This allows for the wheel to rotatefreely without the cable becoming twisted. The brake arm cable 25 has acable stop 32 on the other end that is constrained in a pocket of thebrake arm 28. The rotary ramped lifter 22, linear ramped lifter 21, andthe brake arm 28 have a sufficient hole and slot that allow for thecables to be attached to the part with the balls already swaged. Thebrake arm 28 pivots about a shoulder bolt. The brake arm 28 is biasedsuch that the brake arm 28 is not in contact with the wheel unless aforce is applied by the user by way of a conical spring 31 applying aforce. The brake arm 28 is located such that it drags against the wheel,and not digging into the wheel (e.g., that could cause a sudden completeand un-safe stop). A conical spring 31 is used to allow for a largerrange of motion. The caster wheel nut 30 is used to fasten the baseconnector 16 to inner raceway of the ball bearing that is pressed intothe castor bracket sleeve 27. The caster wheel nut 30 has a counter borethat allows for the retention of the conical spring 31.

The present invention also provides other types of hand braking systems.For example, in some embodiments, a braking system configuration (e.g.,shown in FIGS. 4A-4E) comprising a brake arm 28 utilizes replaceablepads (e.g., brake pads (e.g., thereby making maintenance easier)). Insome embodiments, a hand braking system comprising a cable system asdescribed above is utilized to actuate one or a plurality of brake armsinto the side(s) of a wheel or hub (e.g., the brake arm would berotating on an axis at 90 degrees compared to the configuration as shownin FIGS. 4A-4C).

In some embodiments, the present invention provides a cot comprisingwheels that are easily changeable in order to adapt to a particularenvironment. For example, in some embodiments, a cot user may change cotwheels to a nobbied wheel for an off pavement rescue/recovery (e.g.,through a corn field or forest). In some embodiments, a cot utilizesskis and/or treads (e.g., an adapted tank tread) in place of wheels(e.g., for a snow environment). In some embodiments, a cot of thepresent invention comprises a locking mechanism that engages a pair ofwheels (e.g., the wheels on the foot-end, or the wheels on the head-end)in a fixed, straight position. This type of fixing/locking provides ameans to keep the wheels, and the cot, straight (e.g., allowing the cotto track better (e.g., precluding the cot from getting sideways (e.g.,on inclines))). In some embodiments, because each castor fork 14 canmove independently from the others, this allows a cot of the presentinvention to roll forward (e.g., down or up an incline) at a sidewaysangle. In some embodiments, a castor fork 14 comprises an integratedspring suspension system (e.g., reducing and/or preventing vibrationartifacts, increasing patient/subject comfort, and/or participating in atraction control system).

Castor forks 14 attached to base connectors 16 attached to the head-endcross tube 11 can attach to a foot brake 18 comprising a wheel brakeplate 19 (e.g., as shown in FIG. 3).

As illustrated in the figures (e.g., FIGS. 3 and 8), the head-end crosstube 11 and foot-end cross tube 12 of the base frame 10 attach to legassemblies of the cot 1. For example, the head-end cross tube 11pivotally attaches to a telescoping leg assembly comprising a pair oftelescoping legs 50, and the foot-end cross tube 12 pivotally attachesto a fixed leg assembly comprising a pair of fixed legs 40. The foot-endcross tube 12 of the base frame 10 also pivotally attaches to thehydraulic cylinder base pivot 59, a component of a hydraulic system thatpowers a hydraulic cot system described herein. In some embodiments, thebase frame 10 may comprise a light emitting component (e.g., a light, alight tube, rope light, etc.) that illuminates the base frame and/orsurrounding area (e.g., for nighttime visibility and/or daytime safety(e.g., in the event the cot is utilized to function as a “safety cone,”indicator or other type of barrier)). Additionally, the base frame 10may comprise storage plates (e.g., top mounted storage plate) and/orfasteners (e.g., for attaching other components (e.g., a resuscitationsystem and/or other accessories)). The base frame 10 may be utilized tohouse and/or support a traction control system, suspension package(e.g., independent suspension), and/or attachment components for a cotmounting system.

As illustrated in FIGS. 6-11, an ambulance cot system 1 comprises atelescoping leg assembly comprising a pair of telescoping legs 50. Thetelescoping legs 50 comprise a main rail 51 and an inner rail 55 whereinthe inner rail 55 moves in a telescoping manner within and outward fromthe main rail 51. Experiments were conducted during the development ofembodiments of the invention in order to generate leg assemblies (e.g.,that are part of a cot system (e.g., a hydraulically powered cot system1) that are sturdier, more robust, and more energy efficient (e.g., thatprovide a cot system with longer battery life, less friction and lesshydraulic system pressure (e.g., providing a cot with a longer usablelife and less servicing requirements than other available ambulancecots)). Thus, in some embodiments, the present invention providestelescoping legs 50 comprising a main rail 51 and an inner rail 55,wherein the main rail 51 comprises a top side and a bottom side, whereinthe top side of the main rail 51 comprises an extruded portion 62 thatis fastened to a roller bearing 63 (e.g., as shown in FIGS. 8-11). Theextruded portion 62 comprises a roller mount for fastening a rollerbearing 63. The extruded portion 62 comprises an orifice through whichthe roller bearing 63 extends such that it sits upon the top side of theinner rail 55, and rolls along the top side of the inner rail 55 (e.g.,when the cot is raised or collapsed). As illustrated in FIGS. 8 and 10,the main rails 51 of the telescoping legs 50 are fastened to each othervia a cross tube 56 that is attached to each of the extruded portions 62of the main rails 51.

The cross tube 56 serves multiple functions in a cot system 1 of thepresent invention. The cross tube 56 harmonizes the movement of each ofthe telescoping legs 50 (e.g., the main rails 51 and inner rails 55)when a cot 1 is raised or collapsed. Additionally, the cross tube 56steadies the cot 1 when the cot 1 is raised or lowered (e.g., byabsorbing energy associated with movement about a pivot point of the cot(e.g., that occurs when a cot 1 is raised or collapsed)).

Thus, in some embodiments, the present invention provides a cotcomprising a pair of fixed legs 40 and a pair of telescoping legs 50,wherein the main rails 51 of the telescoping legs 50 are fastened toeach other via a cross tube 56 that is attached to each of the extrudedportions 62 of the main rails 51. In the absence of the cross tube 56,raising and lowering of the cot created excessive telescoping frameflexure (twisting) leading to additional frictional forces at thetelescoping legs. This in turn increased hydraulic system pressures,battery current draw, and produced a less stable cot. Experimentsconducted during development of embodiments of the invention initiallyutilized a cot lacking the cross tube 56.

For example, a cot comprising a pair of fixed length legs and a pair ortelescoping legs was tested for its ability to raise and lower weight(e.g., representing a subject). Tie rods were utilized to relieve thetelescoping legs of excessive sliding friction (between inner rail andouter main rail) due to the large bending moment created by thecylinder's force about the pivot point and acting at the telescopinglegs. However, the presence of the fixed length legs created acircumstance in which the tie-rods were required to expand and contractin length as the cot traveled through it's range of motion. The tie rodlength and placement was determined by analyzing the cot in theretracted, level and raised positions. In each of these threeconfigurations the tie rod was of one length. But, as the cot moved fromone position to the next, the tie rod decreased and increased in length.Thus, there existed a sinusoidal effect on tie-rod length. Thesinusoidal effect on tie-rod length caused excessive side loading of thecylinder rod, which in part led to breakage of a cylinder rod studduring lifting experiments conducted during embodiments of theinvention.

Thus, it was determined that use of a tie rod design did not functionwithin a cot of the present invention (e.g., comprising a pair afixed-length legs and a pair of telescoping legs). Having two legs offixed length precluded the use of tie rods that shared cylinder loadwith the telescoping legs. This in turn led to the need to develop asystem that reduced the effect of the large bending moment on thetelescoping legs. A roller bearing system of the present inventionprovides a solution to this problem.

Also illustrated in FIGS. 8-11, the telescoping legs 50 of the cotsystem 1 of the invention comprise an inner rail 55. The inner railtelescopingly moves inside and outward from the main rails 51. Asillustrated in FIGS. 10 and 11, the inner rails 55 comprise a top sideand bottom side wherein one or more roller bearings 65 are connected toa top portion and one or more roller bearings 65 are attached to abottom portion of the inner rail 55 such that the roller bearings 65roll along the inside face of the top side and the inside face of thebottom side of the main rail 51 (e.g., when the cot is raised orcollapsed). For example, FIG. 11 illustrates one configuration of aroller bearing system of the invention. The main rail 51 is shown in atransparent manner in order to visualize components of the rollerbearing system within the main rail 51. For example, the inner rail 55is shown in grey, comprising a roller bearing 65 present on a topportion (e.g., the roller bearing 65 attached to the inner rail 55 thatis adjacent to the extruded portion 62 of the main rail 51) as well as aroller bearing 65 attached to a bottom portion of the inner rail 55 thatrests upon and rolls along the inside face of the bottom side of themain rail 51. Thus, the present invention provides telescopic movementof the inner rails 55 along and outward from the main rails 51 madepossible by the presence of roller bearings 65 attached to the innerrail 55 that roll along the inside of the main rail 51, as well as byroller bearings 63 attached to the extruded portion 62 of the main rail51 that roll along the top side of the inner rail 55.

The present invention is not limited by the number of roller bearings 65attached to the inner rail 55 (e.g., on a top portion or on a bottomportion of the inner rail 55). For example, an inner rail 55 maycomprise two, three, four, five or more roller bearings 65 attached to atop portion of the inner rail 55 (e.g., that contact and/or roll alongthe inside face of the top side of the main rail 51) and/or two, three,four, five or more roller bearings 65 attached to a bottom portion ofthe inner rail 55 (e.g., that contact and/or roll along the inside faceof the bottom side of the main rail 51). Similarly, the main rail 51 maycomprise a plurality of roller bearings 63 attached to the extrudedportion 62 of the main rail 51. For example, in addition to the rollerbearing 63 attached to the extruded portion 62 of the main rail 51 shownin FIGS. 10 and 11, a cot system 1 of the present invention may compriseadditional roller bearings 63 (e.g., attached to a bottom portion of theextruded portion 62 (e.g., whereby the roller bearing 63 contacts androlls along the bottom of the inner rail 55)). In some embodiments, aroller bearing 63 attached to the extruded portion 62 of the main rail51 comprises a concave surface (e.g., that contacts and rolls along aconvex inner rail 55 surface). In some embodiments, a roller bearing 65attached to an upper portion or a lower portion of the inner rail 55comprises a convex surface (e.g., that contacts and rolls along aconcave main rail 51 surface (e.g., the inside face of the top side orthe inside face of the bottom side of the main rail 51)). The presentinvention is not limited by the type of material utilized for rollerbearings 63, 65. Indeed, a variety of materials are well known to thoseof ordinary skill in the art including, but not limited to, rubber,metal (e.g., steel), plastics, composites, glass, or ceramic. In someembodiments, roller bearings 63, 65 utilized in a cot system 1 of thepresent invention comprise a cross section that matches the profile ofthe inner rail 55 and/or main rail 51 of the telescoping leg 50.

Thus, in some embodiments, the present invention provides a telescopingleg assembly 50 comprising a roller bearing system, wherein the systemcomprises a telescoping leg comprising a main rail and an inner rail,wherein the main rail comprises one or more roller bearings that contactand roll along the inner rail and wherein the inner rail comprises oneor more roller bearings that contact and roll along the inside of themain rail (e.g., during telescoping movement of a portion of the innerrail from within the main rail to a position outside of the main rail).Thus, a roller bearing system of the present invention reducesfrictional force associated with raising and/or lowering a patient on acot (e.g., increasing or decreasing the length of the telescoping legs).As such, a roller bearing system of the present invention providesreduced hydraulic system pressure, less energy draw (e.g., decreasedcurrent drawn from one or more batteries utilized to power a systemdescribed herein), and significantly increases battery, hydraulic systemand overall cot system lifespan. In alternative embodiments, a rollerbearing system of the present invention utilizes any rolling means knownto one of skill in the art (e.g., a polymeric roller or the like (e.g.,DELRIN roller (DUPONT, Wilmington, Del.))) that reduces and/oreliminates sliding friction associated with raising and/or lowering cotlegs (e.g., telescoping legs).

As illustrated in FIG. 7, a main rail 51 may be attached to one or morepieces of material that act as guards 53, 54 of the telescoping legassembly 50 (e.g., that protect the leg assembly (e.g., from ambulancerear bumper) and that protect the exterior roller bearings). Forexample, the main rail may comprise a lower guard 54 and/or an upperguard 53 that protect the telescoping leg components (e.g., the mainrail 51 and inner rail 55) during loading and/or unloading of a cotsystem 1 of the invention into or out of an ambulance. In someembodiments, each inner rail 51 that attach to the head-end cross tube11 of the base frame 10 comprise attachment points (e.g., screw and/ormount holes (e.g., within pivot attachment points 57)) for attachment ofa guard (e.g., plastic or other type of material) that protects the leg(e.g., when being loaded into and/or unloaded from the back of anambulance (e.g., that absorbs contact forces between the cot andambulance)).

FIGS. 8 and 17 illustrate that the telescoping leg assembly 50comprising a main rail 51 and an inner rail 55 pivotally connects to thehead-end cross tube 11 of the base frame 10. In particular, the innerrails 55 pivotally connect 57 to the head-end cross tube 11 of the baseframe 10. As illustrated in FIGS. 14 and 17, the main rails 51 pivotallyconnect 57 to a cross tube 78 residing in a slider housing 75 attachedto a foot-end portion of the top frame 74.

A cot system of the present invention also comprises a fixed legassembly comprising a pair of fixed-length legs 40 (e.g., as illustratedin FIGS. 7, 8 and 17). The fixed length legs 40 are parallel to eachother and pivotally connect 57 to the foot-end cross tube 12 of the baseframe 10 and a head-end cross tube 81 of the top frame 74 (See, e.g.,FIG. 30). In some embodiments, a pair of fixed-length legs provide a cotof the present invention a sturdier, more robust configuration (e.g.,than a cot figured without a pair of fixed-length legs (e.g., comprisingtwo pairs of telescoping legs)). In some embodiments, a pair offixed-length legs (e.g., independently or together with a pair oftelescoping legs comprising a roller bearing system) provide a means ofreducing hydraulic system pressure (e.g., pressure within and/or exertedupon hydraulic system components of a hydraulic system utilized with acot described herein). Moreover, as described herein, a reduction inhydraulic system pressure provides a more energy efficient cot (e.g.,described herein (e.g., that draws and utilizes less energy)).

As illustrated in FIGS. 12 and 17, a pair of pivots 52 are irremoveablyconnected to the main rails 51 of the telescoping legs 50 and to thefixed-length legs 40. The pivots 52 are also connected to a hydrauliccylinder mount 58, that is connected a cylinder cap 70 attached to acylinder 61 and rod 60. The rod end 67 is attached to a cylinder basepivot 59 that is pivotally connected to the foot-end cross tube 12 ofthe base frame 10. The configuration of a cot system 1 shown in FIGS. 12and 17 provides leg assemblies (e.g., fixed leg and telescoping legassemblies) that pivot about an axis that resides below the legsthemselves. Thus, the present invention provides a cot pivot point thatis below the legs (e.g., compared to other cots that pivot about an axisthat runs through the center of the legs). In some embodiments, aconfiguration of a cot of the present invention (e.g., comprising apivot about an axis that resides below the legs) provides a sturdier andmore robust cot. For example, the pivot axis running below the legsallows a fixed-length leg, together with a telescoping leg, to beconfigured such that the cot at its fully collapsed position is lowenough (e.g., comprises a litter seat height of about 15.5 inches to theground, and at its fully raised position is high enough (e.g., comprisesa load wheel height of about 36 inches to be useful (e.g., from anenergy usage perspective (e.g., for loading a subject onto a cot and/orloading a cot carrying a subject onto and/or off of an ambulance)).

In some embodiments, the present invention provides a cot that comprisesa position of the pivot point that satisfies certain requirements. Forexample, in some embodiments, a cot comprising a fixed leg assembly(e.g., comprising one pair of legs of fixed length) and a telescopingleg assembly (e.g., comprising a pair of legs with variable length)comprises a litter seat height that, at the lowest cot position (e.g., afully collapsed position), is around 15 inches from the ground. Thepresent invention is not limited to this height. Indeed, at the lowestcot position (e.g., a fully collapsed position), several differentlitter seat heights are contemplated including, but not limited to,around 9 inches, 10 inches, 11 inches, 12 inches, 13 inches 14 inches,16 inches, 17 inches, 18 inches, or heights below or above theseamounts. In some embodiments, it is preferred to keep the litter asclose to “level” as possible when to cot is at its lowest (e.g., mostcompact) position. Accordingly, in some embodiments, some degree of“negative slope” (e.g., head lower than feet) is tolerated (e.g., due tothe combination of fixed and variable length legs). In some embodiments,the negative slope of the cot when the cot is at the lowest cot position(e.g., is fully collapsed) is around 2 degrees (although lower (e.g., 1degree or less) and higher (e.g., 3 degrees 4 degrees, 5 degrees ormore) are also contemplated). Similarly, in some embodiments, somedegree of “positive slope” (e.g., head higher than feet) is tolerated(e.g., due to the combination of a fixed leg assembly and a telescopingleg assembly). In some embodiments, the positive slope of the cot whenthe cot is at a fully raised position (e.g., when a load wheel 189height of 36 inches or higher is achieved and/or when the litter seatheight is about 43 inches and is around 12 degrees “positive slope”.

In some embodiments, when the litter is in a semi-raised position to apoint at which the litter is approximately parallel to the ground, thelitter seat height is about 28 inches high. In some embodiments, thelitter seat height will be less than 28 inches (e.g., 27, 26, 25, 24inches or less) or more than 28 inches (e.g., 29, 30, 31, 32 or moreinches) when the litter is approximately parallel to the ground. In someembodiments, having the litter seat parallel to the ground at about 28inches from the ground helps to facilitate the transfer of a patient(e.g., to and/or from a bed, to and/or from another cot, etc.).

Thus, a cot system 1 of the present invention comprises a pivot pointthat is fixed about an axis residing below (e.g., that is 0.125 inchesto 0.25 inches below, 0.25-0.5 inches below, 0.5-1.0 inch below, 1.0-1.5inches below, 1.5-2.0 inches below, more than two inches below) thecenterline of the legs (e.g., fixed legs and/or telescoping legs). Insome embodiments, placement of the pivot point location (e.g., fixedabout an axis residing below the centerline of the legs) provides asturdier, more robust, more energy efficient and thereful a more usefulcot.

Additionally, the configuration of a cot of the present inventioncomprising a pivot point axis residing below the centerline of the legsprovides a configuration that keeps the cylinder stroke of the hydraulicsystem short (e.g., making the stroke stronger and less prone tobreaking). For example, a cot of the present invention (e.g., comprisinga pivot point axis residing below the centerline of the legs) comprisesa cylinder stroke (e.g., from a fully collapsed to a fully raisedposition) that is less than 9 inches in length (e.g., that is 8-9 inchesin length, 7-8 inches in length, or shorter (e.g., that permits a cot toraise from a fully collapsed position (e.g., a litter seat height ofabout 15.5 inches or lower from the ground) to a fully raised position(e.g., a maximum height of the load wheels 189 of a load rail assemblyof 36 inches from the ground (See, e.g., FIGS. 1-3 and 35)))).

In some embodiments, the cot is configured to have a cylinder stroke ofno more than 7.5 inches (e.g., from a fully collapsed to a fully raisedposition), although longer (e.g., greater than 7.5 inches) and shorter(e.g., less than 7.5 inches) cylinder stroke lengths are contemplated.Experiments conducted during development of embodiments of the inventionidentified cot configurations (e.g., comprising a telescoping legassembly (e.g., comprising a roller bearing system) together with afixed leg assembly, and a hydraulic system described herein) thatutilizes a preferred cylinder stroke length of about 7.5 inches.

Set-backs were encountered during development of embodiments of theinvention (e.g., involving breakage of the cylinder rod stud ( 9/16inch)) in that initial cot configurations suffered from excessive sideloading of the cylinder rod caused by a sinusoidal effect encounteredwith tie-rod length and cylinder rod characteristics. Prior todevelopment of embodiments of a cot of the present invention comprisinga roller bearing system, it was determined that excessive side loadingof the rod was due to frame flexure and frictional forces that led totelescoping legs binding and the cylinder mounts flexing. Cylinder pivotmounts and the cylinder rod mounts were bending and being deformed. Onlythrough development of deployment of a roller bearing system of thepresent invention was it possible to eliminate side-loading of thecylinder rod (e.g., caused by frictional force as well as the tie-rodsinusoidal effect. Additionally, it was further determined that using acylinder rod with a diameter greater than ⅝ inch (e.g. 1 inch) allowedan increase in the size of the threaded stud (e.g., to ⅝ inch thread) inthe cylinder rod (e.g., providing a more robust system (e.g.,complementing and/or enhancing a roller bearing system describedherein)).

For example, a significant change in system pressure for a 300 poundlift was observed among different cot configurations generated andtested during development of embodiments of the invention. FIG. 66 showsthe maximum system pressure recorded during a hydraulically powered liftof 300 pounds. CUPP-4 shows the maximum system pressure (pounds persquare inch (PSI)) recorded using a hydraulically powered cot comprisingone pair of fixed legs, one pair of telescoping legs, and a pair of tierods 244, as well as a cylinder comprising a ⅝ inch diameter cylinderrod (e.g., as shown in FIG. 63) that lifted weight to a height of 32inches from the ground to the center of the load wheels. Surprisingly,as the height of the litter increased so did the system pressure andenergy needed to raise the cot (e.g., system current). CUPP-5 shows themaximum system pressure recorded using a hydraulically powered cotcomprising one pair of fixed legs, one pair of telescoping legs (withouta roller bearing system), and a pair of tie rods 244, as well as acylinder comprising a 1 inch diameter cylinder rod mounted to aredesigned cylinder mount (e.g., shown in FIG. 64) that lifted weight toa height of 37 inches from the ground to the center of the load wheels.As the height of the litter increased so did the system pressure andenergy needed to raise the cot (e.g., system current). CUPP-6 shows themaximum system pressure recorded using a hydraulically powered cotcomprising one pair of fixed legs, one pair of telescoping legs (withouta roller bearing system), where the telescoping legs were designed to be3.5 inches longer than the legs of CUPP-5 to increase spacing betweenthe bushings, as well as a cylinder comprising a 1 inch diametercylinder rod (e.g., shown in FIG. 65) that lifted weight to a height of37 inches from the ground to the center of the load wheels.

Each of these configurations, CUPP-4, CUPP-5, and CUPP-6 suffered fromhigh system pressures (e.g., required to raise a cot bearing weight)corresponding to a high current draw (e.g., leading to excessive batterydrain, shortened battery life). For example, although the target foreach of these cots had been a peak current draw of 40 amps, each ofthese configurations yielded current draws of 50 amps. Moreover, asdescribed above, the increased system pressure resulted in asignificantly higher load force translated to the frame assembly,thereby causing instability in the cot frame and even breakage of a cotcylinder rod stud.

Only after breaking the cylinder rod stud of the hydraulic system asdescribed above was it determined alternative methods needed to begenerated to displace the weight and forces experienced (e.g., friction)by the fixed and telescoping leg assemblies. Although stronger cot framecomponents were tested, these components led to an undesirable increasein weight of the cot, and were unable to address large energy drawrequired to raise the cot. These setbacks led to the development anddeployment of the roller bearing system within the telescoping legs ofthe present invention. As shown in FIG. 66, a cot comprising a pair offixed length legs and a pair of telescoping legs comprising a rollerbearing system as described herein was determined to significantlyreduce the friction associated with the translation of inner rails 55relative to the outer main rails 51 while raising the legs (e.g.,performing a lift) thereby providing a stronger, more robust cot (See,e.g., FIG. 66, CUPP-7). Moreover, the reduced friction provided by a cotcomprising a pair of fixed length legs and a pair of telescoping legscomprising a roller bearing system as described herein resulted in lowerhydraulic system pressure required for raising the cot (e.g., raising agiven load with the cot (e.g., providing a stronger, more capable cot)).As shown in FIG. 67, lower hydraulic system pressure resulted in lowerbattery power consumption and thus, longer battery life (e.g., a cotthat can be used for a greater period of time without need forrecharging and/or replacement of the batteries).

Additionally, minimizing stroke length required of the cylinder (e.g.,for a given bore) reduced the amount of hydraulic fluid transferred whenraising and/or lowering the cot (e.g., with or without a subject loadedthereon). Thus, the present invention provides a cot system comprisingminimized hydraulic fluid transfer (e.g., resulting in shorter lifttimes, less energy draw from the batteries and therefore longer batterylife).

FIGS. 13-17 illustrate a top frame 74 and components connected theretoand/or part thereof of a cot system of the present invention. Asillustrated in FIG. 13, foot end portions of the top frame 74 areattached to slider housings 75. The slider housings 75 are configured tohold a cross tube 78 attached to the main rail 51 of the telescopinglegs 50. As shown in FIG. 14, the cross tube 78 is connected on bothends to slider blocks 83 that slide within the slider housing 75. Asdescribed below, this configuration provides determination of cot heightinformation used in a cot tip angle monitoring, recording and alertsystem of the present invention. FIG. 13 further illustrates that thetop frame 74 comprises a foot-end cross tube 79, a middle region crosstube 80 and a head-end cross tube 81, wherein the cross tubes 79, 80, 81are fastened to cross tube castings 71 that are fastened to the topframe 74. The top frame 74 fastens to a team lift rail 73 via cross tubecastings 71 and team lift mount extrusions 72 that comprise an orificeinto and/or through which the team lift rail 73 extends. The team liftrail 73 surrounds the foot end region and both sides of the top frame74. The foot end portion of the team lift rail 73 provides a locationfor attachment of a control panel (e.g., user interface) 77 of the cotsystem 1. The control panel may also be attached to a foot end rail/lifthandle 6 attached to the foot end of the top frame 74.

Various components attach to the top frame 74. For example, as shown inFIG. 17, the top frame 74 attaches to a telescoping load rail assembly 4comprising wheels 188 (e.g., utilized for rolling the cot out of andinto an ambulance deck). As shown in FIGS. 35-38, the wheels 188 arepivotably attached to the load wheel forks 191 which are fastened to theload wheel casting 185. The load wheel castings are attached to the loadrail 184 via fasteners 197. The load rail bushings 203 attached to theload rail 184 provide a hard stop against a cap on the top framefastened to the end of the main rail 74, to prevent the load railassembly from being pulled completely out.

As shown in FIGS. 36 and 37, the load rail assembly 4 is extended orretracted by pulling back on the release rod 193. The release rod 193 isattached to load release connectors 192. The release connectors 192 areattached to a release nut. A load release bushing 198 provides a bearingsurface against the load wheel casting 185 for the load rail releasemechanism as it slide within the bore of the load rail. The load releasebushing 198 also acts as a spacer positioning a load release nut that isattached via a socket head screw at the appropriate distance from theload release rod 193. The release nut also provides a pocket into whicha cable stop 196 can be placed. The cable stop 196 is attached to cable195. The opposite end of the cable 195 has a similar cable stop 196which is contained between two mating detent slides 204. When therelease rod 193 is pulled, the cable 195 translates that motion to thedetent slides 204, driving up the spring loaded detent plunger 245 asthe detent plunger pin 246 rides up the ramped surface of the detentslide 204. The release nut bottoms out in a pocket of the load wheelcasting 185 to provide a travel stop.

In some embodiments, and as shown in FIG. 17, the cot comprises atelescoping load-rail assembly 4. In some embodiments, the telescopingload-rail assembly 4 is designed to shorten the overall length of thecot when being used in confined spaces (e.g., narrow hallways, smallelevators, etc.). In some embodiments, the load-rail assembly 4 isreleased by pulling back on a ½″ round tube 193 that runs horizontallybetween the two load-wheel casting fork assemblies 191. This tube 193 isattached to a small connector assembly 192 at each of it's ends. Theseconnector assemblies 192 run axially within the load-rails 184 anddisengage, via cable assembly 195, a spring-loaded lock-pin assembly 201mounted within each load-rail 184. The spring-loaded lock-pin assemblyengages either of two holes placed within each of the outer main rails74 of the litter assembly. One of these two holes provides the standardlength position for the load-rails 184 and the other provides theshortened length. In some embodiments, the telescoping load-railassembly 4 also features a system whereby properly securing the cot in amount system prevents unintentional disengagement of a spring-loadedlock-pin assembly while the cot is secured within an ambulance. Forexample, the pin 201 is used to lock-out the telescoping rail releaserod 193 when in ambulance. The catch bar pivots 187 attached to thecatch bar 188 rotate pivotally about load rail cross tube 186 whenproperly secured in an ambulance. The catch bar pivost 187 push up thespring loaded pin assembly 201. The pin 201 engages a pocket in therelease connector assemblies 192 and prevents the rod 193 from beingpulled.

The fixed legs 40 pivotally attach to the head-end cross tube 81 of thetop frame 74. Hydraulic system tubes (e.g., utilized to form a platform(e.g., to bear the weight) for hydraulic system components (e.g.,hydraulic system power/pump unit 177 and motor 178, fluid reservoir 176and hydraulic pan 163 (e.g., illustrated in FIG. 31))) also attach tothe head-end cross tube 81 of the top frame 74, as well as themiddle-region cross tube 80 of the top frame 74 (e.g., as shown in FIG.26). A gas strut mount 167 used for attachment of a gas strut 168 thatis connected to a head/upper torso litter 164 component of the patientlitter is also attached to the head-end cross tube 81 of the top frame74. One or more batteries 82 also attach to the top frame 74 at thefoot-end cross tube 79 (e.g., as shown in FIG. 13). In some embodiments,a cot of the present invention comprises a non-series wired two batterypower system. The present invention is not limited by the type ofbattery utilized. For example, multiple different types of batteries maybe used with a cot of the present invention including, but not limitedto, lithium-ion, lead acid, nickel metal hydride, nickel cadmium,alkaline (e.g., rechargeable alkaline), hydrogen, and/or solarphotovoltaics. In some embodiments, the battery power system of thepresent invention powers components of the cot (e.g., the electricalcomponents (e.g., the circuit board, controller, processor, memorycomponents, transducers, ultrasonic sensors, accelerometers, etc.) aswell as hydraulic system components (e.g., motor and/or pump)). In someembodiments, cot batteries may enjoy in ambulance charging (e.g., cotbatteries are charged from ambulance shore line (e.g., from cot station(e.g., via cot floor mounting system))). In some embodiments, cotbatteries are charged using mechanical energy (e.g., cot wheelrotation).

Components utilized to attach a patient litter to the top frame 74 alsoattach to the top frame 74. For example, as shown in FIG. 20, a litterleg tube 94 pivotally attaches to a seat pivot tube 96 attached to teamlift mount extrusion 72 attached to the top frame 74 between themiddle-region cross tube castings 71 and the head-end cross tubecastings 71. A litter thigh tube 95 also attaches to the seat pivot tube96. A second seat pivot tube 96 attaches to litter pivots 99 attached tothe top frame 74 and is also located between the middle-region crosstube castings 71 and the head-end cross tube castings 71. The head/uppertorso litter 164 pivotally connects 166 to the second seat pivot tube96. Fasteners can be utilized to attach one or more litter components(e.g., a seat/lower torso litter) to pivot tubes 96 (e.g., pivot tubes96 shown in FIG. 20).

In some embodiments, a patient litter of the present invention comprisesa four section litter comprising a leg litter 152, a thigh litter 159, aseat/lower torso litter 161, and a head/upper torso litter 164. In someembodiments, the litter is made of roto-molded plastic, although theinvention is not so limited. For example, the litter may be made of anyof a variety of materials including, but not limited to, rubber or othertype of composite material. The roto-molded and/or blow-molded patientlitter of the present invention provides superior cleanability comparedto other litters. For example, the solid, flat, non-porous surface ofthe molded litter of the present invention comprises no rivets or othertype of connector into which bodily fluids flow and/or are collected(e.g., that can be hazardous to a cot user (e.g., due to the fluidsand/or blood carrying infectious agents (e.g., HIV))). Furthermore, amolded litter of the present invention does not comprise slats (e.g.,metal slats found on other litters) that often bend and/or dent. Inaddition, the solid, flat, non-porous surface of the molded litter ofthe present invention eliminates hand and/or finger pinch and/orentrapment points present in other litters (e.g., present in slottedaluminum slats). In some embodiments, a molded litter comprises taperedends for maximum safety for a subject transported on the litter (e.g.,the ends function to keep a subject centered on the litter, as well asprovide additional space for a user of the cot to access the team liftrail 73). The solid, flat, non-porous surface of the molded litter ofthe present invention further provides a stronger more even surface thatprovides a uniform surface for a cot mattress (e.g., such that themattress does not displace into a slat (e.g., aluminum slat) hole). Ifscratched or gouged, a blow-molded litter will not rust and may also berecycled. In some embodiments, a molded litter of the inventioncomprises antibacterial properties (e.g., comprises antibacterialplastic).

The present invention is not limited by the type of cot mattressutilized with a cot system of the invention. Indeed, a variety of cotmattresses find immediate use with a cot system described herein.Similarly, future cot mattresses may be designed specifically for usewith a cot system described herein. In some embodiments, mattress designconforms to the unique design of the attachment point position of ashoulder strap harness of the present invention. In some embodiments, acot mattress is constructed of a puncture resistant and/or rip resistantmaterial (e.g., pliable vinyl or similar material). In some embodiments,a cot mattress is heat sealed (e.g., for maximum durability andcross-contamination prevention). In some embodiments, a cot mattress isconstructed of an impervious, non-porous material (e.g. that is easy toclean and/or that comprises anti-microbial properties). In someembodiments, a cot mattress comprises built-in articulation seams (e.g.,for maximum performance (e.g., around the knee gatch and torso jointareas)). In some embodiments, a cot mattress comprises recessedindentions for allowing a user to easily secure fasteners around themattress (e.g., for attachment to the molded litter). In someembodiments, hook and loop fasteners (e.g., 3M DUO-LOCK fasteners) areutilized (e.g., with or without industrial grade adhesive) to attach amattress to the blow-molded patient litter. In some embodiments, a cotmattress comprises a two-tone color pattern (e.g., for increasedvisibility and/or patient alignment upon the mattress). In someembodiments, a cot mattress comprises a padded flap on the head-end(e.g., to cover an oxygen bottle holder present at the head-end of thecot (e.g., for increased patient safety and/or comfort)). In someembodiments, a cot mattress comprises a visoelastic foam (e.g.,TEMPERPEDIC mattress) or other type of memory foam. In some embodiments,a cot mattress comprises a neck roll head support. In some embodiments,a cot mattress is temperature controlled (e.g., utilizing the cotbattery power and/or another power source). In some embodiments,temperature control includes both warming as well as coolingfunctionality (e.g., to warm (e.g., for hypothermia) and/or cool (e.g.,heart condition, heat exhaustion, spinal injury, etc.) subjects residingon the cot). The present invention is not limited by the manner in whicha cot mattress is heated or cooled. In some embodiments, a temperaturecontrolled cot mattress utilizes heat consolidating beads. In someembodiments, a temperature controlled cot mattress utilizes heatedand/or cooled water from an external source. In some embodiments, atemperature controlled cot mattress is reusable and/or disposable. Insome embodiments, a disposable cot mattress is heated and/or cooledusing similar chemical reactions found in a hot pack and or cold pack.In some embodiments, a temperature controlled cot mattress is storedflat on the cot and/or is rolled like a sleeping bag for easy storageand deployment. In some embodiments, a cot mattress comprises a designsimilar to that of a roller bearing warehouse shipping table (e.g., thatassists in moving a subject off of the cot (e.g., onto an emergency roomtable or hospital bed).

In some embodiments, a cot system 1 of the present invention comprisesside rails 76 (e.g., shown in FIGS. 18-20). The side rails 76 arepivotably attached to the team lift rail 73 via side rail pivots 88.Side rail bearings 93 are located within the side rail pivot 88 toreduce friction and wear. The side rails 76 are locked in position by aspring plunger assembly 89. The spring plunger assembly 89 mounts withintwo mating rail lock housings 90 located within the side rail tube 85.The spring plunger 89 is mated with a spring block 91. The spring block91 slides along a ramped surface on a side rail handle 92 which ispivotably attached to the side rail tube 85. As this side rail handle 92is rotated, the pin block 91 slides along the ramped surface, liftingthe spring plunger assembly 89 pin thereby disengaging it from a holelocated in the team lift rail 73 allowing the side rail 76 to be rotatedto the desired position. There are a plurality of holes in the team liftrail 73 into which the plunger assembly 89 pin can engage. In someembodiments, the patient side rails extend out sideways (e.g., toaccommodate a subject that does not fit within the confines of rails notextended out sideways).

In some embodiments, a cot system 1 of the present invention alsocomprises a patient restraint system. In some embodiments, the patientrestraint system comprises a lower leg restraint, lap restraint, and/orupper torso/shoulder restraint. In some embodiments, the restraintsystem comprises restraint attachment points 7 (e.g., present on teamlift mount extrusions 72 (e.g., as shown in FIG. 16)). In someembodiments the restraint attachment point 7 is a shoulder bolt fastenedto the team lift mount extrusion 72. In some embodiments, the restraintshave a quick clip and/or snap clip belt end (e.g., similar to those usedin automobile racing) that attach to the shoulder bolt (e.g., therebyproviding for quick removal). In some embodiments, restraints maycomprise an antimicrobial substance and/or an impervious material (e.g.,that inhibits and/or reduces absorption of bodily fluids (e.g., blood)).In some embodiments, a restraint system of the present inventioncomprises a sensor and/or alert system (e.g., added to a female or malebelt attachment point (e.g., that provides a warning tone when a subjectis not strapped in (e.g., prior to and/or upon movement of anambulance))). In some embodiments, a restraint strap comprises a maleattachment point (e.g., so that if the attachment points on the cot lineup across a subject's joint (e.g., knee, hip, etc.), the strap canattach to itself on the team lift handle (e.g., thereby avoidingstrapping across the joint)).

As shown in FIGS. 29A-29C, a cot of the present invention can be placedinto a number of different positions.

The head/upper torso litter 164 elevation is controlled by a gas chargedspring (strut) 168 (e.g., shown in FIG. 28) that is pivotably attachedto the head/upper torso litter 164 and a strut mount 167 that is affixedto the head-end cross tube 81. This elevation can be changed byactuating the strut release handle 170 that is pivotably attached 171 tothe backrest assembly. Actuating the strut release handle depresses apin 172 within the strut piston rod 169. This allows the gas chargedspring (strut) 168 to extend or contract in length.

The leg litter portion of the cot can be configured into or from a kneegatch position by actuating the knee gatch detent assembly 98 (e.g.,shown in FIGS. 20-24). Depressing the spring loaded knee gatch detentbutton 45 linearly displaces two gatch slides that are slideablyretained within the detent housing 44. The gatch slides retain cablestop 47 which are attached to cable 49. The linear translation of thegatch slides displace the gatch pins 48 which are then disengaged fromtheir respective holes within the litter leg tube 94. This allows theknee gatch detent assembly 98, which is slideably attached to the litterleg tube 94 via the gatch pivot 150, to be repositioned to the desiredconfiguration. The gatch bearing 151 provides a bearing surface for thismotion.

As shown in FIG. 24, the leg litter portion of the cot can be configuredinto a Trendelenburg shock position by lifting up on the foot end of thelitter leg tube 94 until the trendel rod 153 slides from it's downposition along the trendel ramp 154 and becomes engaged in the elevatednotch position along the trendel ramp 154. An elasticized shock cord 156(e.g., a bungee type cord) serves to limit disengagement of the trendelrod 153 from the trendel ramp 154. The shock cord 156 also provides thenecessary force to engage the trendel rod 153 into the trendel ramp 154notch positions. The trendel knob 158 provides a grab point for the userto disengage the trendel rod 153 from the trendel ramp 154 when goingfrom an elevated (Trendelenburg) position to a lowered (flat) position.

In some embodiments, a cot system 1 of the present invention comprises ahydraulic system. As illustrated in FIG. 12, the hydraulic systemcomprises a hydraulic cylinder mount 58 connected to a pair of pivots 52connected to the main rails 51 of the telescoping legs 50 and to thefixed-length legs 40. The hydraulic cylinder mount 58 is connected to acylinder cap 70 attached to a cylinder 61 and rod 60. The cylinder cap70 comprises an orifice through which a cylinder retract line 69extends. The rod end 67 attaches to a cylinder base pivot 59 that ispivotally connected to the foot-end cross tube 12 of the base frame 10.

The hydraulic system can be utilized to raise and lower the legassemblies of the cot (e.g., thereby raising and lowering the patientlitter (e.g., for loading a subject onto the cot and/or for loading acot carrying a subject into an ambulance)). The cylinder 61 and rod 60are powered by a hydraulic unit comprising a hydraulic manifold 174attached to a hydraulic power/pump unit 177 and motor 178 operationallyconnected to a hydraulic fluid reservoir 176. Components of thehydraulic unit are attached to a hydraulic pan 163 that is connected tohydraulic system tubes 162 attached to the top frame 74 as describedabove. FIGS. 32 and 33 illustrates additional components of thehydraulic system including a manifold 174 comprising a spring loadedmanual release cable 180 (e.g., that attaches to a manual release lever212 at the foot-end of the cot, shown, for example in FIGS. 41 and 42),attached to a cable stop 32 capable of moving a pull valve plate 182that actuates manual release valves 181. The manifold 174 also comprisesa spring loaded plunger 179 which actuates the flow control bypass valve107 when the hydraulic system pressure nears 0 psi (e.g., when the loadwheels 189 of a load rail assembly are resting upon the deck of anambulance and the base frame 10 is outside of the ambulance (e.g.,suspended above the ground)). This enables the operator to lift the baseframe 10 in manual mode with less effort, because the hydraulic fluid isnot being forced through the pressure compensated flow control valve108.

FIGS. 44-52 illustrate various valve configurations of a hydraulicmanifold of the present invention (e.g., that permits raising,collapsing, maintaining height of a cot of the present invention as wellas other cot functionality (e.g., manual use of said cot)). FIG. 44illustrates components of a hydraulic system manifold involved inpowered and manual operation of a cot in some embodiments of theinvention.

FIG. 44 shows one embodiment of a valve configurations of a hydraulicmanifold including a bi-rotational power unit 301, pressure releasevalves 302, pilot operated check valve 303, load holding check valve304, controlled lowering valve 305, manual release up valve 306, flowcontrol bypass 307, pressure compensated flow control valve 308, quickcollapse valve 309, pressure transducer 183, velocity fuse 311, checkvalve with orifice 312 and manual release down valve 313.

FIG. 45 shows hydraulic valve configuration during a powered raising ofthe cot (e.g., powered raising of the leg assemblies of the cot (e.g.,powered extension of the hydraulic system cylinder rod outward from thehydraulic cylinder, raising both the fixed leg assembly as well as thetelescoping leg assembly comprising a roller bearing system through apivot axis residing below the centerline of the legs)). The pump 320 isrotated in a direction that supplies fluid to the cap end of thecylinder. Cap end pump pressure causes the pilot operated (P.O.) checkvalve 303 to shift open which allows fluid to return to the pump fromthe rod end of the cylinder. Fluid flows past the load hold check valve(304) as well as the reverse flow check on the pressure compensated flowcontrol 308 on its way to filling the cap end of the cylinder. Fluid isblocked from returning to the tank/reservoir by the controlled lowervalve 305, manual release valve 306 and the quick collapse valve 309.Hydraulic system pressure (e.g., powered raising of the leg assembliesof the cot (e.g., powered extension of the hydraulic system cylinder rodoutward from the hydraulic cylinder)) is monitored by a pressuretransducer 183.

FIG. 46 illustrates valve configuration while maintaining a constantheight of the cot (e.g., of the patient litter (e.g., upon which asubject is held)). For example, when the cot is supporting a load, fluidreturning to tank is blocked by the load holding check valve 304,controlled lower valve 305, manual release valve 306 and the quickcollapse valve 309. The pressure transducer 183 monitors the hydraulicsystem pressure (e.g., generated by the load on the cylinder).

FIG. 47 illustrates valve configuration during a non-powered, controlledcollapse of the legs. The controlled lower valve 305 opens which allowsfluid to bypass the load holding check valve 304. As the cylinderretracts (e.g., due to the litter load and/or other force upon thelitter) fluid is pulled out of the tank through the P.O. check valve303, the free flow side of the orifice check valve 312, and into the rodend of the cylinder. Fluid being pushed out of the cap end of thecylinder flows through the velocity fuse 311 and is forced to flowthrough the pressure compensated flow control valve 308 that controlsthe speed of cylinder retraction. Fluid traveling around the pressurecompensated flow control valve 308 is prevented by the quick collapsevalve 309 and the flow control bypass valve 307. Back pressure createdby the pressure compensated flow control valve 308 is monitored by thepressure transducer 183.

FIG. 48 illustrates valve configuration while manually collapsing a cotbearing weight (e.g., a subject) of the present invention. When themanual lever 212 is pulled (e.g., generating a pulling movement upon themanual release cable 180 that actuates the manual release pull valveplate 182 away from the manifold 174 (e.g., as shown in FIG. 33)) boththe manual down valve 313 and manual up valve 306 are actuated. As thecylinder retracts, due to the litter load, fluid is pulled out of thetank through the manual down valve 313, the free flow side of theorifice check valve 312 and into the rod end of the cylinder. Fluidbeing pushed out of the cap end of the cylinder flows through thevelocity fuse 311 and is forced to flow through the pressure compensatedflow control valve 308 that controls the speed of cylinder retraction.Fluid travel around the pressure compensated flow control valve isprevented by the quick collapse valve 309 and the flow control bypassvalve 307. Back pressure created by the pressure compensated flowcontrol valve is monitored by the pressure transducer 183. Fluid isallowed to travel back to the tank through the manual up valve 306.Thus, a cot system of the present invention provides, in manual mode,regulation of hydraulic fluid by a flow valve. This stands in contrastto other cots in which an unregulated drop of the cot occurs when usedin manual mode (e.g., leading to dangerous conditions for a subjecttransported on such a cot (e.g., risk of rapid, uncontrolled drop)). Inaddition, the velocity fuse 311 also serves to stop the cylinder if ahose is ruptured or loss of fluid or valve malfunction (e.g., if therewere a malfunction, cot would drop only momentarily until the velocityfuse is activated, and when activated, stops all movement of thecylinder).

FIG. 49 illustrates valve configuration during a powered, quick collapseof a cot of the present invention. For example, when the down button isdepressed and the system pressure is below 25 pounds per square inch(PSI) (e.g., when load wheels of a load rail assembly are resting uponthe deck of an ambulance and the leg assemblies are outside of theambulance such that the wheels attached to the base frame are suspendedin air), the pump 320 is turned in a direction that supplies fluid tothe rod end of the cylinder. Fluid passes through the P.O. check valve303 in the free flow direction and into the rod end of the cylinder. Thequick collapse valve 309 opens to allow fluid to travel from the cap endof the cylinder to tank as the cylinder retracts. System pressure ismonitored by the pressure transducer 183 (e.g., that is used to initiatea quick collapse). If system pressure (e.g., monitored by the pressuretransducer 183) rises above 25 PSI the cot remains in quick collapsemode until the down button is released or the cot legs are fullycollapsed/retracted. If an obstacle obstructs collapsing of the legs(e.g., an object is placed in a certain manner so that it interfereswith the movement of the legs) maximum system pressure is limited by therod end pressure relief valve 302. This rod end pressure relief valve isconfigured (e.g., set at a pressure high enough) to reliably lift thelegs without allowing excess system pressure that might damage the cotor an obstacle if the obstacle were obstructing the collapsing motion ofthe legs (e.g., an object is placed in a certain manner so that itinterferes with the movement of the legs) or potentially torquing thecot from the users hands if such an obstacle were encountered.

Thus, the present invention provides a hydraulic system that will notcontinue to force the legs to collapse (e.g., raise (e.g., when loadwheels of a load rail assembly are resting upon the deck of an ambulanceand the leg assemblies are outside of the ambulance such that the wheelsattached to the base frame are suspended in air)) if there is somethingthat impedes the collapsing/raising of the legs (e.g., a bag, portion ofthe ambulance (e.g., metal grates), etc.). Thus, a cot of the presentinvention will not continue to pull the legs upward when impeded,potentially causing damage to the cot and or ambulance. (e.g., metalgrate that lifts up on the tail end portion of many ambulances). Forexample, if the cot (e.g., the cot's hydraulic system) were notconfigured this way, there would exist a significant risk that as thecot were being loaded (e.g., onto the deck of the ambulance) by raisingthe legs using the hydraulic system, if the hydraulic system did notpossess the ability to preclude forcibly raising up (lower) through anobject, the legs would continue to raise up and through the object,causing the cot to tilt as the force from the object exerted on the legsbecomes so great so as to overtake the user's ability to control the cot(e.g., potentially leading to tipping of the cot).

FIG. 50 illustrates valve configuration during a manual collapsing ofthe legs (e.g., when load wheels of a load rail assembly are restingupon the deck of an ambulance and the leg assemblies are outside of theambulance such that the wheels attached to the base frame are suspendedin air). When the manual release lever is pulled (e.g., with the legassemblies suspended in the air) fluid is drawn out of the tank throughthe manual down valve 313 and into the rod end of the cylinder. Fluidtravels around the pressure compensated flow control 308 because systempressure is at zero which causes the spring loaded plunger 179 toactuate the shift of the flow control bypass valve 307 to shift. Fluidis returned to tank through the manual up valve 306.

FIG. 51 illustrates valve configuration that holds the legs in acollapsed position (e.g., when the legs are suspended in the air (e.g.,when load wheels of a load rail assembly are resting upon the deck of anambulance and the leg assemblies are outside of the ambulance such thatthe wheels attached to the base frame are suspended in air)). When thelegs are suspended, the P.O. check valve 303, and the manual releasedown valve 313 prevent fluid from entering the tank/reservoir from therod end of the cylinder.

FIG. 52 illustrates valve configuration during manual lowering of legassemblies (e.g., when load wheels of a load rail assembly are restingupon the deck of an ambulance and the leg assemblies are outside of theambulance such that the wheels attached to the base frame are suspendedin air). When the manual release lever is pulled (e.g., when the legassemblies are suspended in air) gravity pulls the undercarriage down,extending the cylinder. Fluid is drawn out of the tank through both themanual release up valve 306 and the flow control bypass valve 307 intothe cap end of the cylinder. Fluid exiting the rod end of the cylinderis metered by the check valve orifice 312 due to the overrunning loadcondition. The fluid returns to tank through the manual release downvalve 313.

The present invention is not limited by the type of valves utilized asdescribed in FIGS. 44-52. A number of different types of valves may beused in a cot of the present invention including, but not limited to, avalve manufactured and/or sold by PARKER HANNIFIN (Cleveland, Ohio)(e.g., 2-way valve, pull to open valve, normally closed valve, poppettype directional valve, etc.), a valve manufactured and/or sold by SUNHYDRAULICS Corporation (Sarasota, Fla.) (e.g., fixed orifice valve,pressure compensated flow control valve with reverse flow check, 2-way,direct acting, soft shift, solenoid operated directional poppet valve,free flow nose to side check valve, etc.), and/or a valve manufacturedand/or sold by HYDRA FORCE (e.g., a 2-way, push to open, normally closedpoppet type directional valve), among others.

Thus, in some embodiments, controlling (e.g., powering) the raising andcollapsing of leg assemblies (e.g., fixed leg assembly and a telescopingleg assembly comprising a roller bearing system) is performed by ahydraulic system. For example, in some embodiments a hydraulic systemcomprising a hydraulic cylinder comprising a 1.5 inch bore and/or a 1inch diameter rod is utilized. The present invention is not limited bythe size of bore and/or rod diameter. Indeed, in some embodiments,smaller (e.g., less than 1.5 inch) or larger (e.g., larger than 1.5inches) bore diameters are utilized. Similarly, the present invention isnot limited by the size of rod used. In some embodiments, smaller (e.g.,less than 1 inch in diameter) or larger (greater than 1 inch indiameter) are utilized. In some embodiments, a hydraulic systemcomprising a 1.5 inch bore cylinder comprising a 1 inch diameter rodcomprises a 7.5 inch stroke length.

In some embodiments, a cot comprises a hydraulic system comprisinghydraulic fluid that flows at about 0.8 gallons per minute (GPM) (e.g.,when there is no weight (e.g., downward force) upon the cot) when thehydraulic system is utilized to raise and/or lower leg assemblies of thecot. In some embodiments, a cot comprises a hydraulic system comprisinghydraulic fluid that flows at about 0.4 GPM (e.g., when a subjectresides upon the cot) when the hydraulic system is utilized to raiseand/or lower the leg assemblies of the cot. In some embodiments, a cotcomprises a hydraulic system comprising hydraulic fluid that flows at0.48 GPM when the leg assemblies of the cot are collapsed (e.g., duringa quick collapse of the cot).

The cylinder rod is in a retracted position when the cot is collapsed/infully lowered position. As shown in FIG. 12, if raising power is appliedto the hydraulic system, cylinder length extends (e.g., cylinder rod 60extends outward from cylinder body 61), pushing up on cylinder mount 58,wherein the cylinder mount 58 is attached to the telescoping leg pivots52 attached to the fixed legs 40 and the telescoping legs 50, forcingthe telescoping legs 50 to extend and the fixed legs 40 to rise.Concurrently (e.g., as shown in FIG. 14), the slider block 83 attachedto the ends of the cross tube 78 connected to the main rail 51 of thetelescoping legs 50 slides along the slider housing 75 toward thehead-end of the cot, thereby raising the cot (e.g., sliding fromfoot-end (when in collapsed/lowered position) to the head-end portion ofthe slider housing 75). In some embodiments, the hydraulic cylindermount is configured to withstand greater than 3600 lbs of force (e.g.,greater than 3750 PSI, greater than 4000 PSI, greater than 4250 PSI)from the cylinder. While the cylinder 61 and cylinder rod 60 raise thefixed legs 40 and the telescoping legs 50, the cylinder itself pivotsabout the foot-end cross tube 12 via attachment to a cylinder base pivot59 (e.g., via bearings within the pivot). As described above, thedevelopment of a roller bearing system within the telescoping legsprovided by the present invention reduced frictional force associatedwith actuation of the legs, thereby decreasing the force placed uponcomponents of the hydraulic cylinder (e.g., cylinder rod (e.g., therebydecreasing side loads that are created upon the rod and/or cylinder bodyduring raising and lowering of the cot)). This in turn provides lessrisk for damage to the hydraulic system and a stronger and more robustcot system. For example, prior to development of a cot comprising afixed leg assembly and a telescoping leg assembly comprising a rollerbearing system, a cot tested during development of embodiments of theinvention was limited to a 300 pound lift weight. However, a cot of thepresent invention has no problem lifting or lowering weights in excessof 650 pounds. In some embodiments, maximum lift weight of a cot of thepresent invention is limited only by a regulator valve (e.g., a valve302 described in FIG. 44 (e.g., required by regulatory body (e.g., theU.S. Food and Drug Administration) for use as a device to transporthuman subjects)).

The present invention is not limited to any particular hydraulic systempower/pumping unit. Indeed, any bi-rotational power/pump unit finds usein a cot system of the present invention. In some embodiments, a cotsystem of the present invention utilizes a PARKER HANNIFIN bi-rotationalpower unit (e.g., model no. 118BIS32-BRR-1H-07-22-YZ) or similar unit(e.g., that provides a flow rate sufficient for a cot of the presentinvention (e.g., described herein)).

In some embodiments, the present invention provides a tip anglemonitoring, recording and alert system. For example, in someembodiments, a cot system of the present invention comprises a tip anglemonitoring, recording and alert system. A tip angle system of thepresent invention comprises the ability to simultaneously, and in realtime, measure cot load, cot height and cot angle, and utilize each ofthese measurements to calculate tip angle of the cot. As used herein,the term “tip angle,” refers to the position at which a cot (e.g., notbearing a load, or bearing load weight (e.g., of any weight (e.g.,ranging from about 10 pounds to about 1000 pounds))) of the presentinvention has been determined (e.g., experimentally determined viamodeling and/or experiments conducted during development of the presentinvention) to be at that angle at which the cot will tip (e.g.,dependent upon factors such as cot height, load weight, and the angle oflateral (e.g., side-to-side) movement of one or more reference pointsupon the cot (e.g., a 3-axis accelerometer mounted upon the controller'scircuit board) with respect to a horizontal plane that is more or lessperpendicular to the earth's gravitational force). For example, as shownin FIG. 68, tip angle values were calculated by determining the centerof mass 247 for the cot system (e.g., the center of mass for a subjectwas assessed to occur at a height equal to approximately 55% of fullsubject height, acting along his/her central axis, placing the center ofmass generally over the litter seat) at varying litter heights andpatient weight (e.g., for a subject of 100 pounds, 200 pounds, 300pounds, 400 pounds, 500 pounds, or 600 pounds (See, e.g., FIG. 69)). Thepresent invention is not limited by these weights. Indeed, other subjectweights can be measured (e.g., below 100 pounds or above 600 pounds). Inaddition, values of each of the tested weights can be extrapolated todetermine information for weight points falling between two measuredweights. Each of these mass centers were then placed graphically in acot model with a line sketched from each individual center of mass 247to the contact point 248 between the cot wheels and the ground. Thecasters were modeled to be rotated “inward” providing the narrowesttrack width possible. The angles 249 between each of these sketchedlines and vertical was assigned the tip angle of the cot for thatparticular height/load combination. These values were further refinedthrough a collection of empirical data. A cot was loaded with variousweights and physically “tipped” until it reached its tip-over angle.This angle was measured and recorded.

Thus, the present invention provides methods of collecting tip angledata, as well as data comprising tip angle information for anyparticular cot (e.g., comprising a tip angle monitoring, recording andalert system of the present invention). Thus, systems and methods of thepresent invention can be used to determine the tip angle of any cot(e.g., added onto an existing cot to determine, monitor and/or alert asto cot tip angle).

The present invention is not limited by the method of determining loadweight upon a cot of the present invention. In a preferred embodiment,load weight is determined utilizing a pressure transducer 183 housed onand/or within a hydraulic system manifold (e.g., shown in FIG. 34). Thepressure transducer converts hydraulic system pressure information intovoltage information. Thus, in some embodiments, a cot system of thepresent invention utilizes hydraulic system pressure to calculatepatient weight. For example, one or more pressure transducers (e.g.,that is an internal component of a hydraulic system manifold and/or thatplugs into the manifold) are wired to a controller that is configured todetect signals (e.g., analog voltage) from the transducer. As pressurewithin the hydraulic system varies, the transducer will provide adifferent signal (e.g., voltage feedback) to the controller, that isconfigured to monitor the signals (e.g., voltage variations (e.g.,pressure changes)) and to calculate load (e.g., subject) weighttherefrom. As described above, a pressure transducer can monitor variousconditions of the cot (e.g., whether or not a subject is present on thecot) and provide this information to the controller (e.g., that isconfigured to regulate valve configuration within the hydraulic systemmanifold (e.g., to prevent engagement of a quick collapse mode of thecot (e.g., when system pressure is greater than 25 PSI))).

The present invention is not limited to use of a pressure transducer tomonitor load weight upon a cot described herein. For example, othermeans may be utilized to determine load weight including, but notlimited to, use of a load cell, use of a pressure switch, or a combineduse of one or more pressure switches and/or motor current feedback, ormonitoring of motor current correlated to system loads (e.g., as thecurrent is directly related to system pressures).

The present invention is not limited by the method of determining cotheight. In a preferred embodiment, cot height is measured using anultrasonic sensor. For example, as illustrated in FIGS. 14-16, anultrasonic sensor 84 may be attached to and/or housed within the sliderhousings 75 attached to the foot end region of the top frame 74. Theultrasonic sensor 84 measures the distance between the sensor 84 and aslider block 83 attached to the cross tube 78 attached to the main rails51 of the telescoping legs 50. In some embodiments, the distance betweenthe sensor 84 and the slider block 83 represents the distance betweenthe ground and the load wheels 189 of the telescoping load rail assembly184. In some embodiments, an ultrasonic sensor is wired to a controller.In some embodiments, a controller is configured to detect signals (e.g.,voltage signals) from the sensor. Thus, in some embodiments, as thedistance between the sensor 84 and the slider block 83 changes (e.g., asthe slider block 83 attached to the ends of the cross tube 78 connectedto the main rail 51 of the telescoping legs 50 slides along the sliderhousing 75 toward the head-end of the cot (e.g., when the cot is raisedby a hydraulic system described herein)), the sensor 84 provides adifferent signal (e.g., voltage input) to the controller configured tomonitor the signals (e.g., voltage information) and to calculate cotheight (e.g., height of load wheel 189 of a telescoping load railassembly) therefrom.

A cot of the present invention can be programmed to raise to a specificheight (e.g., a specific load wheel height (e.g., of 36 inches) oranother height (e.g., the height from the ground at which the loadwheels are moved into a position on or just above the deck of aparticular ambulance))). For example, because the ultrasonic sensormeasures the distance between the slider block 83 and the ultrasonicsensor 84 (e.g., correlating with the distance the telescoping legs havebeen expanded and the amount both the fixed legs as well as thetelescoping legs have been raised), a user can set a maximum height thatthe cot will raise such that the load wheels are a desired height at themaximum set height (e.g., 28, 30, 32, 34, or more (e.g., 35 or 36) orless (27, 26, 25 or less) inches). Travel beyond a user define maximumset height (e.g., load height) is made possible by removing andreapplying the signal to raise (e.g., re-pressing the up button) untilthe cot reaches it's factory defined end of travel limit.

The ability to program cot height (e.g., using the signal from anultrasonic sensor at the push of a readily accessible button (e.g.,located on the control panel (e.g., See FIG. 55, load height set button115))) is a significant improvement in the field. For example,programmable cot height permits (e.g., at the push of a button (e.g.,located on the control panel)) a user to set the maximum height of thecot (e.g., via a controller sensing signals (e.g., voltage signals) sentby an ultrasonic sensor that correlates to a set height)). This is incontrast to other cots the rely upon other means (e.g., hall effectswitches) placed within difficult to access housing, wherein if a userwanted to re-set the maximum height of a cot, user would be required touse tools (e.g., screwdriver, etc.) in order to open the housing, removethe housing, and then manually reset the max cot height (e.g., bymanually moving a hall effect switch or magnet).

In some embodiments, a controller of the present invention is configuredto store (e.g., in memory) a user set maximum cot height (e.g., set bypressing a load height set button 115 shown in FIG. 55). When a userresets the maximum height of the cot, the previously recorded set heightdata is removed from memory and the new set height data is recorded init's place.

The present invention is not limited by the method of determining theangle of lateral movement of one or more reference points upon the cot.For example, in a preferred embodiment, one or more of the referencepoints used to determine angle of side-to-side movement of the cot ishoused upon a circuit board housed in the controller housing. Forexample, a reference point may comprise an accelerometer located withinand/or upon a circuit board housed in a controller.

In some embodiments, one or more reference points comprise otherlocations upon the cot including, but not limited to, one or morelocations on the top frame (e.g., including, but not limited to, alocation on one of the cross tubes (e.g., top frame foot-end cross tube,top frame middle region cross tube, top frame head-end cross tube)connected to the top frame 74), one or more locations on a patientlitter (e.g., let litter, thigh litter, seat/lower torso litter, and/orhead/upper torso litter), one or more locations on a leg assembly (e.g.,fixed leg assembly and/or telescoping leg assembly), or other part of acot provided herein.

In a further preferred embodiment, one or more of the reference pointscomprise an device configured to monitor lateral, side-to-side movement(e.g., an accelerometer, gyroscope, etc.). In some embodiments thedevice is an accelerometer. In some embodiments, an accelerometer ismounted upon a circuit board housed within the controller housing (e.g.,as shown in FIG. 13, that is located between and attached to the teamlift rail 73 and foot end rail/lift handle 6 that surround the foot endregion of the cot) and is in informational contact with a controller. Insome embodiments, a controller is configured to detect signals (e.g.,voltage signals) from the device (e.g., accelerometer) configured tomonitor lateral movement. Thus, in some embodiments, as theaccelerometer detects lateral movement (e.g., the angle of lateral(e.g., side-to-side) movement of the circuit board with respect to ahorizontal plane drawn through the circuit board (e.g., through theaccelerometer) that is more or less perpendicular to the earth'sgravitational force), the accelerometer provides a different signal(e.g., voltage input) to the controller configured to monitor thesignals (e.g., voltage information) and to determine the angle of thecot (e.g., the degree of movement away from the horizontal plane drawnthrough the circuit board) therefrom.

In some embodiments, tip angle values are calculated by using apre-determined and/or pre-calculated center of mass for a cot system(e.g., comprising a subject) and/or subject. For example, in someembodiments, the center of mass for a subject is calculated to occur ata height equal to approximately 55% of full subject height, acting alongits central axis. Thus, in some embodiments, this places the center ofmass for a subject approximately over the litter seat. This center ofmass is then factored into the center of mass for an unloaded and/orloaded cot for varying subject weights at varying cot heights (e.g., thecenter of mass is determined for patient weight at varying litterheights and patient weights (e.g., for patient weight values of 100,200, 300, 400, 500 and 600 pounds). Each of these mass centers is thenplaced graphically in a cot model with a line sketched from eachindividual center of mass to the contact point between the cot wheelsand the ground (e.g., with the caster forks rotated “inward” providingthe narrowest track width possible). The angles between each of thesesketched lines and vertical can be designated the tip angle of the cotfor each particular height/load combination (e.g., measured angle can beprogrammed into a cot system as the tip angle, or, the angle can havedegrees added to it or subtracted from it and this modified angle canthen be programmed into a cot system of the present invention). In someembodiments, the center of mass is calculated to occur at a differentlocation (e.g., not over the litter seat (e.g., over the thigh litter orupper torso litter). In some embodiments, the tip angle can beprogrammed at a lower value than that of its actual value (e.g., inorder to accommodate patient comfort concerns).

Experiments conducted during development of embodiments of the inventionfurther refined these values through the collection of empirical data.For example, a cot was loaded with various weights and physically“tipped” until it reached the angle at which the cot tipped over. Thisangle was measured and recorded.

As shown in FIG. 69, the present invention provides specific angles atwhich a cot will tip (e.g., depending upon the cot angle, weight uponthe cot and/or the height at which the cot is raised).

Thus, the present invention thus provides the ability to determine thetip angle of any cot (e.g., comprising a tip angle monitoring, recordingand alert system as described herein). For example, if futureimprovements are made to a cot of the present invention, it will bepossible to use the same type of system and/or procedure to identifyand/or characterize tip angle data. Additionally, a tip anglemonitoring, recording and alert system of the present invention can beadded onto any existing cot (e.g., retrofitted onto existing cots). Inthis way, existing cots can be made safer (e.g., by alerting a user ofthe cot to unsafe operating conditions (e.g., unsafe operational anglesof the cot)). In some embodiments, a tip angle monitoring, recording andalert system is utilized to customize cot design (e.g., used to design acot that is sturdier and/or more robust (e.g., less likely to tip)).

In some embodiments, the cot is configured to provide an audible and/orvisual alarm in the event the side-to-side angle of movement of the cotapproaches and/or reaches an angle at which the cot will tip (e.g.,depending upon cot angle, load weight and/or litter height). In someembodiments, the audio alert comprises a pulsed tone signal and/or asolid tone signal. For example, in some embodiments, a pulsed tonesignal sounds when the cot angle reaches a position that is within acertain specified (e.g., pre-set) range from the tip angle (e.g., atfive degrees, four degrees, three degrees or less from the angle atwhich the cot has been determined to tip (e.g., under certain weightand/or height conditions (e.g., provided in a tip algorithm (e.g.,programmed into and/or housed within the cot's controller (e.g., withina firmware component of the controller)))))). In some embodiments, asolid tone signal sounds when the cot reaches a preset angle at whichthe cot will tip or a certain number of degrees (e.g., three degrees,two degrees, one degree) from the angle at which the cot will tip (e.g.,as determined in real time by the tip angle monitoring, recording andalert system (e.g., utilizing a tip angle algorithm (e.g., programmedinto and/or housed within the cot's controller (e.g., within a firmwarecomponent of the controller))).

The present invention is not limited to any particular controller.Indeed, a variety of controllers may be utilized to receive (e.g., froma transducer, sensor, and/or angular movement sensing device), process,and/or send information regarding cot usage. For example, controllersthat find use in the present invention include, but are not limited to,a 32 bit microcontroller (e.g., that utilizes a reduced instruction setcomputing (RISC) microprocessor). In some embodiments, a controllerutilized in the present invention integrates a 12-bit analog-to-digitalconverter (ADC), queued serial peripheral interfaces (QSPI), and/or afour channel general purpose timer (GPT) (e.g. capable of pulse widthmodulation (PWM)). The present invention is not limited to anyparticular controller. Indeed, any controller comprising one or more ofthe functions described above can be utilized herein. In someembodiments, a cot of the present invention utilizes a FREESCALECOLDFIRE MCF52210/MCF52223 microcontroller.

In some embodiments, a controller stores data in non-volatile flashmemory, which communicates with the microcontroller via a serialperipheral interface (SPI) bus. During operation of the cot, themicrocontroller is configured to save and access a variety of dataincluding load height and calibration information (e.g., as describedherein). Calibration information is used to convert pressure information(e.g., captured by a pressure transducer) into weight information (e.g.,subject weight upon the cot). The controller is also configured to logevents into a memory component (e.g., flash memory) of the cot. In someembodiments, the events logged include serial number, event, date andtime, lift time, battery 1 status, battery 2 status, weight, height,system pressure, and/or service code.

In some embodiments, a controller is configured to consider one or aplurality of scenarios. For example, a controller can be configured tosort through a look-up table (e.g., a table described in FIG. 69) todetermine the angle of tip for a given height (e.g., height asdetermined from ultrasonic sensor signal) and weight (e.g., asdetermined from pressure transducer signal). In this scenario, the tipmonitoring, recording and alert system warns of unsafe operating anglesduring transport of the cot to and/or from an ambulance (e.g., ifrolling across uneven terrain). A controller can also be configured tosort through a look-up table (e.g., a table described in FIG. 69) todetermine tip height for a given weight (e.g., as determined by pressuretransducer signal) and angle (e.g., as measured by a 3-axisaccelerometer). In this scenario, the tip monitoring, recording andalert system warns of a lift (e.g., beyond a certain height) of apatient positioned on an angle (e.g., on the side of a hill or otherterrain) causing the cot to not sit level (e.g., for which liftingbeyond a particular height could cause the cot to tip). In someembodiments, a controller is configured to record cot height, weightupon the cot, degree of movement of cot, and/or tip angle of cot (e.g.,into memory storage means (e.g., a hard drive, disk, memory card, etc.)during usage of the cot.

As described herein, in some embodiments, height is measured by anultrasound transducer (e.g., that provides an analog voltage to the ADCon the microcontroller. In some embodiments, the voltage is linearlyproportional to the cot height (e.g., the higher the cot, the higher theoutput voltage of the transducer). In some embodiments, to determinesubject weight upon a cot, a pressure transducer first provides ananalog voltage to the ADC on the microcontroller. In some embodiments,the microcontroller then calculates subject weight upon the cotaccording to the direction of movement of the cot.

For example, if the cot is rising, the weight is calculated as:PW=(SP−LP)*CMUwherein PW equals patient weight; SP equals system pressure; LP equalslift litter pressure; and CMU equals calibration multiplier up.

In some embodiments, lift litter pressure is determined in calibrationmode, when the litter is lifted and lowered empty. The CMU is thendetermined in calibration mode as:CMU=CW/(SP−LP)wherein CW equals calibration weight; SP equals system pressure; and LPequals lift litter pressure. In some embodiments, the calibration weightis set to a weight that represents an empty cot litter or other setweight (e.g., 100 pounds, 200 pounds, 300 pounds). In some embodiments,the calibration weight is set to 200 pounds.

If the cot is moving down, subject weight is calculated as:PW=(SP−LP)*CMDCMD equals calibration multiplier down; DP equals down litter pressure;SP equals system pressure; and LP equals lift litter pressure. Similarto lift litter pressure, down litter pressure is determined with anempty cot in calibration mode. CMD is then determined in calibrationmode as:CMD=CW/(SP−DP)wherein CW equals calibration weight; SP equals system pressure; and LPequals lift litter pressure. In some embodiments, the calibration weightis set to 200 pounds.

In some embodiments, cot height, weight upon the cot and cot angle areall utilized to determine tip angle (e.g., the tip condition). In someembodiments, to determine angle of the cot, axis values are provided tothe microcontroller by a 3-axis digital output linear accelerometer. Insome embodiments, the accelerometer provides the microcontroller withmeasured acceleration signals through a serial peripheral interface,which is read by the microcontroller every 70 ms. In some embodiments,the microprocessor then converts these axis values to angle values as:xAngle=(oldXAngle+(newXAxis/11.3777))/2

In some embodiments, although the microprocessor calculates an angle foreach axis (xAngle, yAngle, zAngle), only the xAngle is used to determinea tip condition. In some embodiments, the microcontroller compares thexAngle to two tip angles, an alarm angle and a warning angle. An alarmangle is determined, as described herein, using a two dimensionallook-up-table that has been constructed according to the independentvariables of height and weight. In some embodiments, the warning angleis then calculated as: warning angle=alarm angle−a certain amount ofdegrees (e.g., 5, 4, 3, 2, or 1 degrees).

The xAngle is then compared to the tip angles to determine a tipcondition. If the xAngle is less than the warning angle, the systemcontinues to operate normally. If the xAngle is greater than or equal tothe warning angle but less than the alarm angle, the system enters intothe warning state (e.g., the microcontroller initiates a pulsed tonesignal to be sounded from a speaker within the controller housing and/ora light illuminates upon the user interface). If the xAngle is greaterthan or equal to the alarm angle, the system enters the alarm state(e.g., the microcontroller initiates a constant, solid tone signal to besounded from a speaker within the controller housing and/or a lightilluminates upon the user interface).

In some embodiments, in the warning state, an audible alarm pulsates onand off. In some embodiments, if the system enters into the alarm state,the audible alarm changes to a constant, solid tone. In someembodiments, if the cot is in the process of rising when the alarm stateis reached, the microcontroller will interrupt the rise (e.g., inhibitthe user's normal ability to raise the cot by pushing the raise button).In some embodiments, if a user desires to increase height despite thewarning, a user may do so by releasing and repressing the up/raisebutton. The cot will continue to rise, albeit in a slower ‘jog’ mode.

In some embodiments, a look up table utilized by the controllercomprises angle and weight as independent variables. For example, whenweight and angle are independent variables, the microcontroller willreview the table to determine the maximum height before a tip conditionis reached. Thus, the existing cot height is then compared to themaximum height, to generate both a warning state and an alarm state.

In some embodiments, the tip angle monitoring, recording, and alertsystem captures and records cot operational use information. In someembodiments, recorded cot operational use information is stored in amemory component (e.g., present on a circuit board housed within thecontroller housing). In some embodiments, cot operational useinformation comprises cot angle (e.g., all angles recorded by the tipangle system described herein (e.g., any angle of the cot that isoutside a range (e.g., three degrees) approaching the tip angle of thecot (e.g., an angle at which a cot is parallel to a horizontal planethat is perpendicular to the earth's gravitational force), angles of thecot that are within a range (e.g., three degrees or less) of the tipangle, angles that are equal to the tip angle and/or angles that aregreater than the tip angle (e.g., calculated for a cot)))). The presentinvention is not limited by the type of cot operational use informationrecorded and stored. For example, cot operational use informationincludes, but is not limited to, cot angle, cot height, cot load weight,calendar date, time, identification of user, etc. In some embodiments,cot operational use information comprises unsafe cot operational angles.

In some embodiments, a cot of the present invention is configured tohave multiple modes of operation. For example, in some embodiments, acot of the present invention operates in a “System Ready,” “InAmbulance,” “Sleep,” and/or other type of mode. In a “System ReadyMode,” the cot is fully operational (e.g., all systems are functioning).For example, the electronic controller is monitoring system pressure,cot height and cot angle. In the “System Ready Mode,” the controller canalso be configured to allow the transfer of data (e.g., via USB or othertype of port) and can display patient weight (e.g., on the control panel(e.g. in pounds and/or kilograms (e.g., in a 3 digit, 7-segment LED)))upon request. In an “In Ambulance” mode, the controller is configured toallow for the transfer of data as well as to display load weight (e.g.,last recorded load value) upon the cot (e.g., subject weight (e.g., onthe control panel)). In some embodiments, a cot is configured to betriggered to enter this mode by a magnet located within the deck of anambulance (e.g., in an ambulance's mount system). The magnet trips ahall effect switch 207 located in a slider assembly 75 of the cot (e.g.,See FIG. 39). In a “Sleep Mode” the controller monitors hydraulic systempressure and cot angle. In some embodiments, when the cot enters “SleepMode,” the cot system is configured to recall the last recorded heightof the patient litter (e.g., when the cot re-enters “System Ready Mode”(e.g., for the purposes of tip angle detection)).

A cot of the present invention may comprise one or more hall effectswitches. For example, a cot of the present invention may comprise ahall effect switch that, when triggered, kills all power to hydraulicsystem (e.g., via sending a signal to a controller that in turn killsall power to the hydraulic system). In some embodiments, a hall effectswitch capable of shutting down power to the hydraulic system, asdescribed above, is located in a position that, when the cot is loadedonto the ambulance, a magnet located in the ambulance triggers theswitch thereby shutting down power to the hydraulic system and/or othersystems of the cot.

A cot of the present invention may comprise a second hall effect switch.For example, a second hall effect switch may be present on the foot-endportion of the slider housing, such that when the cot is in the downposition, the cot (e.g., a cot's controller) can perform a“self-calibration.” For example, when the cot is in a down position, amagnet located in a portion of the top frame 74 (e.g., within thefoot-end cross tube 79 (e.g., within a bearing residing in the foot-endcross tube)) triggers the hall effect switch (e.g., that is sensed bythe controller) that then instructs the controller that the cot is inthe down position, at which point the controller calibrates theultrasonic sensor (e.g., to correlate with height). For example, if thehall effect switch is tripped, indicating that the cot is in the down(e.g., fully collapsed position) and the cot is registering a heightthat is incompatible with this position (e.g., higher than the fullycollapsed position), then the controller (e.g., present on the circuitboard) records this and indicates that there is a problem (e.g., withthe ultrasonic sensor and/or hall effect switch). Additionally, smalloffsets may be used to calibrate the ultrasonic sensor to compensate foratmospheric changes. In some embodiments, if large offsets are requiredor a continual shift with smaller offsets over time occurs, the sensormay be identified as faulty. In the event the sensor is determined to befaulty then a service condition occurs (e.g., a service requiredindicator alert appears on the control panel and the sensor is no longerused to determine height (e.g., the controller is programmed to assume acot litter height equal to the factory setting (e.g., for tip sensefunction purposes) unless the foot-end hall effect switch isactivated)).

Thus, a cot of the present invention comprises the ability to monitor,record and store a variety of run data (e.g., patient run data). Forexample, a hall effect switch can be triggered by a magnet in anambulance to determine when a run (e.g., use of the cot by a user (e.g.,EMT, EMS provider, etc.) begins (e.g., when the switch is triggered fromon to off this indicates that the cot has been removed from ambulance),and, likewise, when a run ends (e.g., when it is triggered from off toon, indicates that the cot is back in the ambulance). All cotoperational use information can be monitored, recorded and stored by thetip angle monitoring, recording and alert system provide herein (e.g.,from the beginning of a run to the end of a run). For example, eachtriggering of the hall effect switch can be used to group cotoperational use information into a specific cot run (e.g., a specificusage of the cot by a specific user at a specific time).

A cot of the present invention also comprises other ways to determine ifcomponents of the cot are failing and/or have failed. In someembodiments, there are several ways of determining pressure transducerfailure. For example, when the cot is in the full down position andresting on stops present on the base frame, there exists a constanthydraulic system pressure (e.g., that can be recorded (e.g., by thecontroller)). If the full down position hydraulic system pressure isover the recorded amount then the transducer is identified as beingfaulty. In some embodiments, if at any time the transducer gives anoutput less than a certain voltage (e.g., less than one volt) thetransducer will be identified (e.g., by the controller) as being faulty.In the event the transducer is identified as being faulty then a servicecondition occurs and the sensor is no longer used to determine weight.In some embodiments, under a transducer fault condition, the cot isconfigured to assume that a 600 lb patient is always present upon thecot.

In some embodiments, a cot of the present invention comprises a pole forplacement of one or more intravenous (IV) fluid bags. For example, asshown in FIGS. 57-62, the IV pole 213 rotates about two separate andoffset axes allowing it to not only fold down from the in use position,but to stow underneath the patient litter. In the stowed configurationthe end of the pole 213 snaps into a IV clasp 214 that holds the pole inplace when not in use (See, e.g., FIG. 57). The user pulls the IV Stage1 229 to disengage it from the IV clasp 214 and continues to rotate thefolded pole 213 approximately 210 degrees so that the IV pivot housing215 is vertical (See, e.g., FIG. 58). The IV pole 213 then rotates aboutthe IV pivot housing pin 217 and bearing 218 until it is in line withthe IV pivot housing 215, approximately 90 degree (See, e.g., FIG. 59).In some embodiments, the pole 213 can continue to rotate past 90degrees. The IV position grip 216 then can be pushed down onto the IVspring pin assembly 221 and compress the IV spring pin assembly spring222. The IV spring pin assembly 221 is now located by a hole in the teamlift handle 73 and IV pole locating block 225 and the IV pivot housings223 are also located in the IV position grip 216. The IV position grip216 is stopped when the IV position grip dowel pins 220 come in contactwith the IV pivot housing 223. This prevents the assembly from havingany rotation about aforementioned 2 axes. Turning the IV position grip216 approximately 90 degrees and then releasing allows the IV spring pinassembly spring 222 to push the IV spring pin assembly 221 up which inturn pushes the IV grip dowel pins 220 up and into a relief in the IVpivot housing 223. At that point the IV position can be neither raisedup nor twisted.

The second stage 230, when extended, is held in place by a compressionfitting 234. The 3^(rd) stage 236 is held in place by flexible stamping(flat spring) 237 that protrudes out when the IV stage 3 236 is pulledout from inside the IV stage 2 230, similar to an umbrella.

The IV pole locating block 225 is located inside of the team lift handle73 via 2 screw holes that are used to also capture the IV sleeve bearingtop 224 and IV sleeve bearing bottom 226. There is an additional holethat captures the IV spring pin assembly 221 when it is pushed down.This is done to increase the amount of engagement, and stability of thepole, of the pin, rather than just having the pin located by a hole inthe team lift handle 73.

The IV sleeve bearing top 224 and IV sleeve bearing bottom 226 areattached to the team lift handle 73 (e.g., by one or a plurality ofscrews). They provide a bearing surface for the IV pivot housing 223 torotate on and also provide an over travel stop when the stowed andfolded pole is rotated up.

The IV pivot housing 223 has several functions including, but notlimited to attaching the IV pole 213 to the team lift handle 73, viafasteners around the team lift handle 73 and to is constrain the IVpivot pin 219 (e.g., constrains the IV pin assembly 221, both the minorand major diameter); possessing a shelf feature to contact the IV sleevebearings 224,226 to prevent over travel; and slot features that allowfor retention of the IV position grip dowel pin 220.

IV spring pin assembly 221 minor diameter is used to prevent motionbetween the IV pivot housing 223 and the IV pole locating block 225. Themajor diameter is used as bearing surface between the IV position gripdowel pin 220. The diameter and thickness are sufficient enough thatwhen the pin is raised the slots in the IV pivot housing 223 forretention of the IV position grip dowel pin 220 are closed. This is doneto prevent foreign objects (e.g., clothing, IV tubes, etc.) from gettingcaught in the slot and damaged when the IV position grip 216 is pulleddown.

The IV spring pin assembly spring 222 is used to bias the IV spring pinassembly 221 up and out of the team lift handle 73. IV position grip 216retains the IV position grip dowel pins 220. In addition the IV positiongrip 216 slides over the IV pivot housing 223 to lock out one of theaxis of rotation. The IV position grip dowel pins 220 contact the IV pinassembly 221 and hold it down against the IV spring pin assembly spring222. They also provide the lockout features to the IV pivot housing 223.

The IV pivot pin 219 has features that allow it to rotate about the IVpivot housing pin bearing 218. It is slotted to allow clearance for theIV position grip dowel pins 220. An additional slot allows retention ofan E-ring 228. There are also features to allow for IV Stage 1 229retention. The IV pivot housing pin 217 helps retain the IV pivothousings 223 and is the axle for the IV pivot pin 219. It is knurled tocreate better retentions in the IV pivot housings 223. The IV pivothousing pin bearing 218 provides a smooth bearing surface for the IVpivot pin 219. The E-ring 228 snaps onto the IV pivot pin 219 andprovides a surface for the IV position grip spring 227 to push on.

The IV position grip spring 227 provide an upwards bias force to the IVposition grip 216 to make sure that the grip 216 is clear of the IVpivot housing 233 when folding. Thus, in some embodiments, an IV pole213 of the present invention reduces and/or eliminates damage caused bya user not pulling the lock out tube up far enough.

The IV stage 1 229 helps provide the necessary height for the IV baghook 242 to allow for IV Bag fluid to flow. It is threaded at one end toallow for the IV collet 233 to be attached, slides over IV pivot pin 219and is retained by a roll pin 232.

The IV collet bushing 235 is located on top of IV Stage 1 229 and isused as a bearing between the IV collet 233 and the IV colletcompression ring 234. It has a chamfered edge that the IV colletcompression ring 234 sits on to help decrease the normal acting on theIV collet compression ring 234 (e.g. thereby reducing friction (e.g.,wear)). This allows the IV collet compression ring 234 to compress anddecompress repeatedly.

The IV collet compression ring 234 is used to apply pressure to the IVStage 2 230 and hold it in place. The IV collet 233 and the IV colletcompression ring 234 have chamfered surfaces, that when the IV collet233 is screwed down the IV Stage 1 229, it cause the IV colletcompression ring 234 to decrease in diameter. This decrease in diametercauses the ring to tighten onto the IV Stage 2 230. There is a slot inthe IV collet compression ring 234 to allow for the decrease indiameter.

The IV Stage 2 230 helps provide the necessary height for the IV baghook 242 to allow for IV bag fluid to flow. On the lower end it allowsfor the retention of the IV Stage 2 bottom cap 231. There is a form areaat the top that provides a stop for the IV Stage 3 bottom cap 239, toprevent the IV Stage 3 236 from coming completely out of the IV Stage 2230. On the upper end it allows for a flange bearing 238 to be pressedin that the IV Stage 3 locking spring 237 rests upon.

IV Stage 2 bottom cap 231 provides a tighter fit to the IV Stage 1 229and a better bearing surface.

IV Stage 3 236 helps provide the necessary height for the IV bag hook242 to allow for IV bag fluid to flow. On the lower end it slides overand allows for the retention of the IV Stage 3 bottom cap 239 by a rollpin 232. It also has slots that allow for the IV Stage 3 locking spring237 to be retained. On the upper end it slides over the IV Stage 3 topcap assembly 241 and is retained by a roll pin 232.

IV Stage 3 bottom cap 239 retains an O-ring 240 that provides a tighterfit to the IV Stage 2 230 and acts to window lock the IV Stage 3 236.The window locking prevents a free fall in the event the IV Stage 3locking spring 237 is depressed and then the IV Stage 3 236 is let go.

IV Stage 3 locking spring 237 protrudes out of the IV Stage 2 230 whenthe IV Stage 3 236 in pulled out a sufficient distance. When the IVStage 3 locking spring 237 is flexed out, it prevents the IV Stage 3 236from falling down. IV Stage 3 top cap assembly 241 allows for an IV bagto be attached to the IV pole 213.

The pre-hospital arena (e.g., treatment (e.g., with one or morepharmaceutical drugs) of a subject prior to arrival at a hospital) issubject to many problems related to pharmaceutical drug protocols. Forexample, problems range from security (e.g., for controlled substancessuch as opiates (e.g., morphine)), inappropriate storage temperature,absence of proper dosing/presence of drug delivery error, poor lighting,lack of record keeping and event recording procedures, and inefficientprocurement/restocking, accountability. Thus, in some embodiments, thepresent invention provides a drug bag and/or drug box (e.g., thataccompanies and/or attaches to a cot of the present invention) thataddresses these problems.

A drug bag/box of the present invention provides a secure system tohandle narcotics generally carried by pre-hospital service teams (e.g.,EMS, EMTs, etc.) as part of their patient pain management (e.g., opiatessuch as morphine) and/or seizure control (e.g., valium) protocols. Thus,a drug bag/box of the present invention provides a security system thatreduces and/or eliminates employee theft of drugs (e.g., narcotics).

A drug bag/box of the present invention also provides a controlledenvironment for drugs that are required to be maintained at a certaintemperature for efficacy. Many intravenous and intramuscular drugs fallvictim to extreme temperatures that fall outside of the manufacturesspecified storage temperature for the drug to retain drug efficacy. Forexample, extreme heat in the South and Southwest regions of America canelevate internal drug bag/box temperatures well over 100 degrees (e.g.,while a drug bag/box is stored in an external vehicle compartment in anambulance/rescue vehicle that is out of the station. Cold temperaturesare also an issue during the winter northern climates. Even in adepartment's vehicle bay, drugs can be subject to temperatures thatexceed the maximum or minimum limits. In general, the stated temperaturerange on most pre-hospital drugs is 59° F. to 86° F. degrees (15° C. to30° C.). Thus, in some embodiments, the present invention provides adrug temperature bag/box that maintains an internal temperature (e.g.,at, within or near the suggested storage temperature (e.g., between 59°F. to 86° F. degrees, although lower (e.g., less than 59° F.) and higher(e.g., greater than 86° F.) temperatures may be maintained)). In someembodiments, the drug bag/box can be used when attached to a cotdescribed herein, whereas in other embodiments, the bag/box can beremoved and carried (e.g., using a strap and/or handle) away from a cot(e.g., to places not accessible to the cot).

A drug bag/box of the present invention can also be used for accuracy indosing. For example, a drug bag/box may comprise a dosing system (e.g.,that identifies a drug pulled from the bag and provides suggested dosage(e.g., based on patient weight, age, medical status, etc.). Thus, insome embodiments, the present invention provides a drug bag/box thatdecreases and/or eliminates administration of the wrong medicationand/or drug and/or dosage of the same. In some embodiments, a drugbag/box of the invention provides identification of the proper sequenceto administer two or more drugs. In some embodiments, a drug bag/boxcomprises a lighting system (e.g., that provides sufficient light toilluminate a scene (e.g., for reading a label on a bottle).

The present invention also provides a drug bag that records removal ofdrugs from the bag and/or the type and/or amount of drug administered(e.g., to a patient/subject in the field). For example, in someembodiments, a drug bag recording system replaces other methods ofdetermining what and/or how much of a certain drug or medication wasadministered (e.g., counting empty packaging on an ambulance floorand/or writing present on a glove or medical tape used by the emergencymedical service provider or on the provider's hand). In someembodiments, the drug bag is integrated with an event recording system(e.g., to monitor and record what was done (e.g., therapy provided) andin what order and time events occur (e.g., if a proper order wasfollowed (e.g., whether defibrillation shocks were delivered and whatdrugs were given in between the shocks and/or after the shocks)). Thedrug bag may also be used for procurement and restocking and/oraccountability. For example, restocking the drug bag after a call is arequirement. The drugs may come from the hospital pharmacy (which is notMedicare lawful) and/or from suppliers that ship the medications. Inthis more common practice, the service is subject to ordering errors,shipping errors, receiving errors, etc. With EMS having a 24/7/365response liability to the community, the EMS service should beperforming drug bag inventory checks after and before each shift change.A drug bag (e.g., utilized with a cot of the present invention)addresses these needs.

In some embodiments, the present invention provides a temperaturecontrolled drug bag (e.g., for use in combination with a cot system(e.g., hydraulic cot system) of the present invention). For example, insome embodiments, the drug bag is utilized by an emergency medicalservice provider (e.g., an emergency medical technician) or other personprior to arrival of a subject at a hospital. The drug bag may compriseheating and/or cooling functionality. In some embodiments, a drug bagcomprises bar code verification (e.g., to identify a proper user (e.g.,that is accessing the bag)), or to identify that the correct drug and/orcorrect dose is being retrieved from the bag. In some embodiments, adrug bag comprises a voice prompt verification system. In someembodiments, a drug bag comprises a RFID tag narcotic authorizationsystem. A drug bag for use with a cot system (e.g., hydraulic cotsystem) may comprise auxiliary lighting, an event recording system,and/or an inventory control system. In some embodiments, the drug bag isbattery powered.

In some embodiments, the present invention provides software that tracksand/or manages data collected, recorded and stored by a tip anglemonitoring, recording and alert system of the present invention. In someembodiments, the software comprises setup, import, search, report and/orbackup functionalities. In some embodiments, the software comprises aset-up function that allows a user to configure the program to behavethe way the user desires (e.g., collection of data in a specific way(e.g., by date, user, patient weight, cot angle, etc.). In someembodiments, retrieval of information from a memory component of a cotsystem of the present invention is password protected. In someembodiments, data can be exported into any type of database (e.g.,MICROSOFT EXCEL, ACCESS, SQL database, etc.). In some embodiments, thesoftware comprises import functionalities that permit a user to removedata from the cot (e.g., from a memory component of the cot (e.g., viaUSB, cable, wireless technology). In some embodiments, importing datacomprises importing information associated with each “run” of the cot(e.g., that are identified by a serial number assigned (e.g., by thecontroller) to each run). In some embodiments, the software comprises asearch function that allows a user to search for specific data (e.g.,imported from the memory component). For example, a user can search fordata specific to a particular user of a cot, all data related to aparticular cot, data related to specific events (e.g., failure data(e.g., sensor and/or transducer error, battery low error, etc.)), datarelated to a specific date and/or time, data related to a specific rangeof subjects transported on the cot (e.g., all subjects with a weightwithin the range of 275-375 pounds) etc.). Thus, the search functionallows a user to select only that data that the user is interested in.The software is also configured to permit generation of results basedupon search criteria (e.g., tables and/or diagrams for reports).

In some embodiments, software configured to track and/or manageinformation and/or data collected, recorded and/or stored by a tip anglemonitoring, recording and alert system of the present invention ishoused and/or run on a personal digital assistant (PDA), a personalcomputer (PC), a Tablet PC, a smartphone. In some embodiments, thesoftware is configured to run independently of other software. In someembodiments, the software is configured to run within or together withother software including, but not limited to, WINDOWS (e.g., WINDOWS XP,WINDOWS CE, or other WINDOWS based operating system), JAVA, cell phoneoperating systems, or other type of software. In some embodiments,information and/or data collected, recorded and/or stored by a tip anglemonitoring, recording and alert system of the present invention iscommunicated to a software configured to track and/or manage suchinformation via BLUETOOTH, ZIGBEE, infrared, FM, AM, cellular, WIMAX,WIFI, or other type of wireless technology. In some embodiments,information and/or data collected, recorded and/or stored by a tip anglemonitoring, recording and alert system of the present invention is madeavailable over a network (e.g., TCP/IP, SANS, ZIGBEE, wireless, wired,USB, and/or other type of network) or via mobile information recordingdevices (e.g., flash card, memory stick, disc, jump drive, etc.). Insome embodiments, a network is configured to comply with certaingovernment protocols (e.g., Health Insurance Portability andAccountability Act rules and/or regulations, Joint Commission on theAccreditation of Healthcare Organizations rules and/or regulations,and/or other types of rules and/or regulations). In some embodiments,software configured to interact with a cot system of the presentinvention comprises a mobile resource a cot user in the field. Forexample, in some embodiments, software is configured to provide a userof a cot of the present invention a variety of information including,but not limited to, drug information (e.g., prescription drug, herbaland/or over the counter generic and trade names (e.g., with extensivekinetics and mechanism of action information)), drug compatibilityinformation (e.g., permitting a user to identify items that can be usedinterchangeably between different manufactures and applications (e.g., auser can determine whether a certain IV line is compatible with certainIV catheters (e.g., thereby decreasing the confusion for a userregarding compatibility between standard IV products and needleless IVproducts))), administration protocols, instructional videos, decisiontrees, inventory information, or other types of information.

In some embodiments, a cot system of the present invention comprises amultiple layer system (e.g., in which all pieces can operateindependently, but are design to integrate with one another for optimalpatient transport and care). For example, in some embodiments a cotsystem comprises a top rigid litter, a middle critical care litter,and/or a bottom hydraulically powered base component.

In some embodiments, the top rigid litter comprises a litter that storesflat when not in use (See, e.g., FIGS. 53A-53B). In some embodiments,the top rigid litter comprises a padded surface (e.g., for optimalpatient comfort and/or to reduce pressure points). In some embodiments,the padded surface comprises one or more antimicrobial substances (e.g.,that prevent microbial growth and/or cross-contamination). In someembodiments, the rigid litter has an adjustable upper torso piece thatcan put a patient into an optimal position for comfort and positioningfrom flat to a 67 degree elevation. This adjustment accommodates for amultitude a patient care presentations including, but not limited to,intubations, head trauma and/or breathing difficulty. In someembodiments, the rigid litter has a fowlers knee-gatch position (e.g.,knees bent at about a 135 degree angle (See, e.g., FIG. 54 (e.g., foroptimal patient comfort and/or positioning (e.g., for the treatment oflower extremity wounds, lower torso injuries, etc)). The rigid litterhas a trendelenberg position with elevates the legs to a 15 degree anglefor the treatment of volumetric blood loss and systematic shock. In someembodiments, the rigid litter includes adjustable patient arm rails formaximum comfort and for arm positioning for optimal intravenous catheterstarts in the arm and/or hand. In some embodiments, the arm rails assistin the arm positioning for optimal blood pressure acquisition. In someembodiments, the rigid litter includes fore and aft telescoping handlesfor optimal manual lifting of the patient. The telescoping handles arepositioned to provide a clinician with an optimal power lifting positionand hand comfort. In some embodiments, the ergonomic handles are largerand are a specific left hand and right hand design which is human factorengineered. In some embodiments, the rigid top litter comprises its ownset of wheels for rolling the patient to the transport area. In someembodiments, the rigid top litter comprises an attachment point for auniversal telescoping pull handle. In some embodiments, the designprovides optimal pulling positioning for a multitude of clinicianheights and pull angles. In some embodiments, the rigid top littercomprises tubular arches that attach into receptacles providing climatecontrolled air (e.g., from an external source). In some embodiments, thearches have a fan-folding privacy canopy that would help maintain thedesired temperature.

In some embodiments, a multiple layer system comprises a critical carelitter (e.g., below a top rigid litter and above a bottom hydraulicallypowered base component). In some embodiments, the critical care littercomprises all of the diagnostic hardware and system software. In someembodiments, the middle layer interfaces with the top litter and thebottom power cot base. In some embodiments, the middle layer is designedto be used with the top rigid patient litter, but could also be usedindependently by placing the patient on top of the litter. In someembodiments, the middle litter comprises a centralized touch screendisplay (e.g., that deploys from a stowed position inside the litter,pulls out and then up for use). In some embodiments, the screen has a360 degree swivel base for complete situational viewing. In someembodiments, the centralized touch screen provides a complete diagnosticdisplay of devices used with the cot in a single view (e.g., that can beindependently selected for specific diagnostic information and history).In some embodiments, the screen may be rotated for clinician viewing(e.g., from an isle between stacked litters (See, e.g., FIG. 54)). Insome embodiments, the middle litter comprises a computer processor(e.g., central processing unit (e.g., that runs an industry standardoperating system)). In some embodiments, the CPU interfaces withspecific hardware component modules. In some embodiments, the modulesare swappable and comprise specific medical devices for patient carefunction. The present invention is not limited by the type of modules.Indeed, a variety of modules may be used including, but not limited to,electrocardiogram (EKG) (e.g., a 3-lead and/or 12-lead based EKG); pulseoximeter (SPO2) (e.g., finger tip based and/or ear lobe or refractive);end tidal carbon dioxide (ETCO2) device; oxygenation device (e.g., thelitter utilizes an embedded oxygen cylinder comprising a clinicianselectable regulator for preset oxygenation levels (e.g., in liters perminute (e.g. 10LPM, etc.))); a defibrillation device (e.g., comprisinghands free defibrillator pads (e.g., that operate in manual mode), thatprovide cardioversion and pacing for advanced personnel and/or AED(Automated External Defibrillation) for mass casualty response and basiclevel care providers; a blood pressure device (e.g., comprising anautomated oscillometric design for optimal readings of diastolic,systolic and pulse); a temperature gathering device (e.g., comprising atympanic membrane (ear) based device); a ventilation device (e.g., aventilator that operates via its own power (e.g., for optimal care in anaeromedical environment)); an aspiration device (e.g., a battery basedsuction pump that would have variable clinician controls for low to highsuction pump speed); an intravenous (IV) pump and infusion device (e.g.,comprising clinician selectable control for drip rate, and fluidchallenge management); a climate control device (e.g., comprising anarch delivery design providing a clinician the ability to provide warmor cooled air to the patient); a toxic gas analysis device (e.g.,comprising sensors for monitoring for exposure to gases such as CarbonMonoxide (CO), Methane, etc.); and/or a blood glucose device. In someembodiments, the critical care litter comprises dedicated storagecompartments (e.g., that pull out from each side of the litter). In someembodiments, the litter comprises a 28V lithium ion battery scheme(e.g., comprising two or more batteries (e.g., 2 or more (e.g., 3, 4, 5or more) batteries for each litter) that comprise indicators of powerlevel left in each one). In some embodiments, the critical care litterand the power base utilize the same batteries. In some embodiments, thecritical care litter and the power base utilize independent batteries(e.g., for maximum reliability). In some embodiments, a set of team lifthandles are provided on each side of the litter (e.g., for manuallifting (e.g., in optimal power lifting positions (e.g., if the powerbase is not deployed))). In some embodiments, a rigid three arch patientclimate control module attaches to the litter and provide for patientprivacy and isolation (e.g., via contamination fan-fold curtains)). Insome embodiments, the arches deliver controlled temperature air via blowhole ports (e.g., that is contained within the fan-fold canopy). In someembodiments, the litter comprises a body fluid channel (e.g., thatcollects and/or measures patient output). In some embodiments, fluidsdrain into a dedicated, disposable container. In some embodiments, thechannel provides a collection medium for other medical drainage (e.g.,blood, decontamination washing, eye washing, etc.). In some embodiments,the litter comprises a receptacle for a telescoping pull handle. In someembodiments, the litter comprises a dual IV pole design that telescopesto length and tucks and folds away when not in use. In some embodiments,the litter comprises a flexible “snake light” (e.g., that can be formedinto position and provides a clinician specific spot or flood lightingproperties). In some embodiments, a higher intensity LED lighting arraymay be incorporated (e.g., for specific light for IV starts, etc. inlower lighting conditions). In some embodiments, the base of the littercomprises embedded, rotating caster wheels (e.g., for ease in rollingthe litter on a deck floor into mounts. In some embodiments, the middlelitter comprises receptacles on the bottom of the litter for posts usedin stacking the litters together vertically. In some embodiments, thelitter comprises a universal connector port that interfaces withpre-plumbed cables providing the litter power, data, oxygen line andsuction line (e.g., from a centralized unit).

In some embodiments, a multiple layer system comprises a base powerassembly. In some embodiments, the base assembly attaches to one or bothof the top two litters for transport. In some embodiments, the powerbase comprises an aluminum constructed x-frame comprising wheels and abattery powered hydraulic system that raises and lowers the one or morelitters. In some embodiments, the powered base is universally attachableto one or both litters (e.g., it may be dedicated on the ground forloading a plurality of litters into vehicles (e.g., ambulances,aircraft, other types of carriers) one after the other (e.g., a litterwould mount in the vehicle allowing the base ready for loading the nextlitter). In some embodiments, the base may stay with the litter (e.g.all three components; top litter, critical care litter and power basewould go with the patient to a final destination). In some embodiments,the base frame, leg assemblies and hydraulic system described herein arecomponents of the base power assembly. In some embodiments, othercomponents of a cot system described herein are also components of thepowered base (e.g., hand-lever operated brake).

In some embodiments, stacking the top two litters (e.g., without thepower base) is enabled by a top litter and middle litter that haveintegrated, cam-lock actuated tubular “legs”. Once actuated from thestowed flat position to a locking upright position, the bottom of theleg inserts into female holes that are evenly spaced throughout ansuitable patient transport carrier (e.g., aircraft floor, truck bed,etc.). In some embodiments, litters are stacked as shown in FIG. 54.

In some embodiments, software associated with the critical care littercomprises data integration of a patient's event history, vital signs,care delivered, time stamping documentation, etc. to a centralizedcomputer.

In some embodiments, a cot of the present invention comprises a 12 volt(V) power supply 114 (e.g., shown in FIG. 55). The 12V power supply 114can be used to power a variety of ancillary cot components including,but not limited to, LED lighting (e.g., used to illuminate patient,surrounding terrain, etc.), 12V power equipment or other devices. Insome embodiments, the 12V power supply draws its power from the cotbatteries 82 (e.g., plurality of 28V lithium-ion batteries).

Having described the invention in detail, those skilled in the art willappreciate that various modifications, alterations, and changes of theinvention may be made without departing from the spirit and scope of thepresent invention. Therefore, it is not intended that the scope of theinvention be limited to the specific embodiments illustrated anddescribed.

All publications and patents mentioned in the above specification areherein incorporated by reference. Various modifications and variationsof the described method and system of the invention will be apparent tothose skilled in the art without departing from the scope and spirit ofthe invention. Although the invention has been described in connectionwith specific preferred embodiments, it should be understood that theinvention as claimed should not be unduly limited to such specificembodiments. Indeed, various modifications of the described modes forcarrying out the invention that are obvious to those skilled in therelevant fields, are intended to be within the scope of the followingclaims.

1. A hydraulically powered cot, wherein said cot comprises: A) a pair offrames, wherein said pair of frames consist of: 1) a base frame, whereinsaid base frame comprises a foot-end cross tube and a head-end crosstube, wherein each of said cross tubes are fastened on each end to aconnector, wherein a first connector attached to said head-end crosstube is irremovably attached to a first rail that is irremovablyattached to a first connector attached to said foot-end cross tube, andwherein a second connector attached to said head-end cross tube isirremovably attached to a second rail that is irremovably attached to asecond connector attached to said foot-end cross tube; and 2) a topframe, wherein said top frame comprises: i) a slider housing affixed tosaid foot-end portion of said top frame; ii) a telescoping load railassembly, wherein said assembly comprises wheels that are utilized forrolling said cot out of and into a deck of an ambulance; and iii) aplurality of cross tubes and cross tube castings, wherein said pluralityof cross tubes comprise a foot-end cross tube, a head-end cross tube anda middle region cross tube, wherein said top frame is attached to a teamlift rail, wherein said team lift rail surrounds the foot-end region andboth sides of said top frame, wherein said team lift rail located on oneside of said top frame is attached to said team lift rail located on theother side of said top frame via said plurality of cross tubes and crosstube castings, wherein said cross tubes are fastened to said cross tubecastings, wherein said castings are fastened to said top frame andcomprise an orifice into and/or through which said team lift railsextend; B) a patient litter formed of roto-molded plastic, wherein saidpatient litter is a four section litter comprising lower leg, upper leg,lower torso and upper torso sections; C) a fixed leg assembly comprisinga pair of fixed-length legs, wherein said fixed-length legs are parallelto each other, and wherein said fixed-length legs are pivotablyconnected to said foot-end cross tube of said base frame, and whereinsaid fixed-length legs are pivotably attached to said head-end crosstube of said top frame; D) a telescoping leg assembly comprising a pairof telescoping legs, wherein said telescoping legs are parallel to eachother, and wherein said telescoping legs comprise: 1) a main rail,wherein said main rail comprises a top side and bottom side, whereinsaid top side of said main rail comprises an extruded portion fastenedto said main rail that comprises a roller bearing, wherein said rollerbearing rolls along the top side of an inner rail when said cot israised or collapsed, wherein said main rails are fastened to each othervia a cross tube that is irremovably attached to each of said extrudedportions of said main rails, and wherein said main rails are attached toa cross tube residing in said slider housing affixed to said foot-endportion of said top frame; and 2) an inner rail, wherein said inner railcomprises a top side and a bottom side, wherein one or more rollerbearings are connected to a top portion and one or more roller bearingsare connected to a bottom portion of said inner rail, wherein saidroller bearings roll along the inside face of said top side and theinside face of said bottom side of said main rail when said cot israised or collapsed, wherein said inner rails are pivotably attached tosaid head-end cross tube of said base frame, wherein said rollerbearings reduce frictional force associated with increase in length ofsaid telescoping legs that occurs with raising of said patient litterand the frictional force associated with the decrease in length of saidtelescoping legs that occurs with lowering of said patient litter; E) ahydraulic system, wherein said hydraulic system comprises a cylinderpowered by a hydraulic unit, wherein one end of said cylinder isattached to a cylinder base pivot, wherein said cylinder base pivot ispivotably attached to said foot-end cross tube of said base frame, andwherein the other end of said cylinder is attached to a cylinder crossmember, wherein said cylinder cross member is fastened to each of saidmain rails of said telescoping legs; F) a tip angle monitoring,recording and alert system, wherein said tip angle system comprises: 1)a pressure transducer, wherein said pressure transducer is locatedwithin said hydraulic system, detects hydraulic system pressure andconverts said pressure to voltage information; 2) an ultrasonic sensor,wherein said ultrasonic sensor is mounted on said slider housing,wherein said ultrasonic sensor measures the distance between said sensorand a slider block attached to said cross tube attached to said mainrails of said telescoping legs residing in said slider housing, whereinsaid distance represents the distance between the ground and said wheelsof said telescoping load rail assembly; and 3) a circuit board, whereinsaid circuit board is located in a controller housing fastened to lifthandles surrounding said foot-end of said top frame, wherein saidcircuit board comprises: i) a controller, wherein said controllermonitors and records said voltage information of said pressuretransducer, wherein said controller processes said voltage informationto calculate load weight on said cot; ii) a processor; iii) a memorycomponent; iv) an accelerometer, wherein said accelerometer isconfigured to measure in degrees the angle of movement from side to sideof said circuit board with respect to a horizontal plane that isperpendicular to the earth's gravitational force; and v) a firmwarecomponent, wherein said firmware is configured to calculate and recordtip angle of said cot utilizing: a) cot load measured by said pressuretransducer; b) cot height measured by said ultrasonic sensor; and c) cotangle measured by said accelerometer; wherein said system furthercomprises a tip angle algorithm, wherein said processor uses saidalgorithm to determine in real-time the cot tip angle of said cot; G) anon-series wired, two battery power system, wherein said system powersthe hydraulic and electrical components of said cot; and H) a controlpanel, wherein said control panel comprises icon indicators for serviceinformation, hydraulic system information, and tip angle information;wherein said cot is configured to raise and lower a subject.
 2. Thehydraulically powered cot of claim 1, further comprising handlever-operated brakes.
 3. The hydraulically powered cot of claim 1,wherein said tip angle monitoring, recording and alert system capturesand records cot operational use information.
 4. The hydraulicallypowered cot of claim 3, wherein said cot operational use informationcomprises unsafe cot operation angles.
 5. The hydraulically powered cotof claim 3, wherein said cot operational use information is selectedfrom the group consisting of cot angle, cot height, cot load weight,calendar date, and time.
 6. The hydraulically powered cot of claim 1,wherein said tip angle monitoring, recording and alert system comprisesaudio and/or visual alerts that warn a user of an unsafe cot tip angle.7. The hydraulically powered cot of claim 6, wherein said audio alertcomprises a pulsed tone signal and a solid tone signal.
 8. Thehydraulically powered cot of claim 7, wherein said pulsed tone signalsounds when said cot tip angle is three degrees or less from the tippingpoint of said cot.
 9. The hydraulically powered cot of claim 7, whereinsaid solid tone signal sounds when said cot tip angle reaches thetipping point of said cot.
 10. The hydraulically powered cot of claim 1,wherein said tip angle monitoring, recording and alert systemcommunicates with said controller to preclude raising of said cot whensaid cot tip angle reaches three degrees or less from the tipping pointof said cot.
 11. The hydraulically powered cot of claim 1, wherein saidcot comprises a weighing function comprising a push button on saidcontrol panel, wherein when said push button is pressed, a cot loadweight is displayed on said control panel of said cot.
 12. Thehydraulically powered cot of claim 1, wherein said memory componentcomprises one or a plurality of memory chips.
 13. The hydraulicallypowered cot of claim 12, wherein said memory component stores cotoperational use information.
 14. The hydraulically powered cot of claim13, wherein said cot operational use information is only accessible toan administrator.
 15. The hydraulically powered cot of claim 1, whereinsaid firmware component is accessible via a USB port.
 16. Thehydraulically powered cot of claim 3, wherein said cot operational useinformation is removed from said memory component using a USB port. 17.The hydraulically powered cot of claim 1, wherein reducing frictionalforce of said telescoping legs reduces hydraulic system pressure. 18.The hydraulically powered cot of claim 1, wherein reducing frictionalforce of said telescoping legs reduces battery current draw.
 19. Thehydraulically powered cot of claim 1, wherein said cot further comprisesone or more hall effect switches configured to regulate power to saidhydraulic system.
 20. The hydraulically powered cot of claim 1, whereinsaid subject weighs up to six hundred pounds.